Medical Radiology and Radiation Safety. 2026. Vol. 71. № 3
DOI:10.33266/1024-6177-2026-71-3-42-52
E.V. Plotnikov1, 2, 3, V.I. Chernov2, 5 , R.V. Zelchan5, M.S. Larkina1, 2, M.V. Belousov1, 2, N.A. Konstantinova4, A.A. Artamonov4
Potential of Exosomes Application in Therapy and Prevention of Radiation-Induced Tissue Damage
1 Siberian State Medical University, Tomsk, Russia
2 National Research Tomsk Polytechnic University, Tomsk, Russia
3 Mental Health Research Institute, Tomsk, Russia
4 Institute of Biomedical Problems, Moscow, Russia
5 Cancer Research Institute, Tomsk, Russia
Contact person: E.V. Plotnikov, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.
ABSTRACT
Purpose: To summarize current trends in exosomal therapy for radiation damage, including biological mechanisms, clinical applications, potential benefits, and technological advances to address issues related to reducing unwanted radiation-induced biological damage.
Material and methods: The review was conducted within the framework of the PRISMA 2020 guidelines. The Google Scholar search engine was used to search for publications. The search query included the phrase treatment radiation “therapeutic exosomes” – review and was formulated to select materials on the stated topic and review articles. The search depth was 5 years from 2021 to 2025 inclusive.
Results: The analysis and summary of current studies of the biological mechanisms underlying recovery after radiation using exosomes, a comparative analysis of the clinical use of exosomes derived from mesenchymal stem cells, identification of therapeutic benefits, comparison of technological innovations, and analysis of problems associated with integration into clinical practice were performed. These data demonstrate that exosomes promote repair of radiation injury primarily by transferring microRNAs, proteins, and lipids that regulate immunomodulation, angiogenesis, and DNA repair, although some exosome profiles may worsen injury. Early clinical data suggest safety and efficacy, as well as advantages over cell-based therapies, but standardization and long-term data remain limited. Therapeutic benefits include anti-inflammatory, anti-fibrotic, and regenerative effects in multiple tissues, facilitated by advances in exosome engineering that allow for increased efficacy, targeting, and functional load of exosomes. However, scalability, heterogeneity, and regulatory barriers hinder translation into clinical practice.
Conclusion: The potential of exosomes as a cell-free therapeutic for the treatment of radiation injury is demonstrated, while standardized protocols and rigorous clinical validation are needed to realize the therapeutic potential of exosomes.
Keywords: radiation damage, exosomes, mesenchymal stem cells, regenerative medicine, immunomodulation, cell-free therapy.
For citation: Plotnikov EV, Chernov VI, Zelchan RV, Larkina MS, Belousov MV, Konstantinova NA, Artamonov AA. Potential of Exosomes Application in Therapy and Prevention of Radiation-Induced Tissue Damage. Medical Radiology and Radiation Safety. 2026;71(3):42–52. DOI:10.33266/1024-6177-2026-71-3-42-52
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Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.02.2026. Accepted for publication: 25.03.2026.