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Sequential Regenerative Activation of Cavernosal Tissue using Low-intensity Extracorporeal Shockwave Therapy and Systemic Exosome Administration in Neurogenic Erectile Dysfunction

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Original Article | Vol 6 | Issue 1 |  January-June 2026 | page: 9-13 | César Eisner

DOI: https://doi.org/10.13107/jrs.2026.v06.i01.191

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted Date: 28 Mar 2026, Review Date: 02 Apr 2026, Accepted Date: April 2026 & Published: 30 June 2026

Author: César Eisner [1]

[1] Shockwave Argentina, Ciudad Autónoma de Buenos Aires, Argentina.

Address of Correspondence
Dr. César Eisner,
Shockwave Argentina, Ciudad Autónoma de Buenos Aires, Argentina.
E-mail: shockwaveargentina@gmail.com

Abstract

Introduction: Neurogenic erectile dysfunction (NED) results from injury to the cavernous nerves and is characterized by impaired nitrergic signaling, tissue hypoxia, endothelial dysfunction, and progressive fibrotic remodeling of the corpora cavernosa. Current treatments primarily address symptoms rather than underlying regenerative mechanisms.
Objective: The objective of the study is to propose a mechanistically guided regenerative therapeutic model combining low-intensity extracorporeal shockwave therapy (Li-ESWT) with systemic administration of mesenchymal stem cell-derived exosomes to promote neural repair and restore the cavernosal neurovascular microenvironment.
Materials and Methods: A conceptual therapeutic protocol is described based on the biological interaction between shockwave-induced mechanotransduction and chemotactic recruitment of regenerative extracellular vesicles through activation of the stromal-derived factor-1 (SDF-1)/C-X-C chemokine receptor type 4 (CXCR4) axis.
Results: Li-ESWT induces transient upregulation of angiogenic and chemotactic mediators including vascular endothelial growth factor, endothelial nitric oxide synthase, and SDF-1, generating a temporary regenerative microenvironment. Systemically administered exosomes expressing CXCR4 receptors may preferentially migrate toward tissues with increased SDF-1 expression, facilitating targeted delivery of regenerative signaling molecules capable of promoting neural regeneration, angiogenesis, and antifibrotic modulation.
Conclusion: Sequential activation of tissue mechanotransduction followed by systemic exosome administration may represent a biologically guided regenerative strategy for NED. This approach constitutes the conceptual basis for the PROSIN protocol, a multimodal regenerative therapy designed to restore penile neurovascular function.
Keywords: Neurogenic erectile dysfunction, Extracorporeal shockwave therapy, Exosomes, Regenerative medicine, Stromal-derived factor-1 C-X-C chemokine receptor type 4 axis, Cavernous nerve regeneration

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How to Cite this article: Eisner C | Sequential Regenerative Activation of Cavernosal Tissue using Lowintensity Extracorporeal Shockwave Therapy and Systemic Exosome Administration in Neurogenic Erectile Dysfunction. | Journal of Regenerative Science | Jan-Jun 2026; 6(1): 09-13.

 

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Autologous versus Non-autologous Exosomes: Immunological, Safety, and Regulatory Considerations in Regenerative Medicine

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Original Article | Vol 5 | Issue 1 |  January-June 2025 | page: 31-33 | Ivanny Marchant, Belén Rodríguez, Valentina Pozo, Leopoldo Parada, Carla Salvo, Pablo Olivero

DOI: https://doi.org/10.13107/jrs.2025.v05.i01.167

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted Date: 16 Mar 2025, Review Date: 20 May 2025, Accepted Date: May 2025 & Published: 30 Jun 2025

Author: Ivanny Marchant [1], Belén Rodríguez [1], Valentina Pozo [1], Leopoldo Parada [2], Carla Salvo [3], Pablo Olivero [1]

[1] Unidad de Estudios Clínicos, Escuela de Medicina, Universidad de Valparaíso, Chile,
[2] Centro de Medicina Regenerativa CITOMED, Viña del Mar, Chile,
[3] Centro de Sangre y Tejidos de Valparaíso, Chile.

Address of Correspondence
Dr. Pablo Olivero,
Unidad de Estudios Clínicos, Escuela de Medicina, Universidad de Valparaíso, Chile.
E-mail: pablo.olivero@uv.cl

Abstract

Small extracellular vesicles (sEVs), commonly referred to as exosomes, have emerged as novel therapeutic tools in regenerative and esthetic medicine. A critical decision in their clinical application is the choice between autologous and non-autologous products, as this distinction directly impacts safety, immunocompatibility, efficacy, and regulatory compliance. This review analyzes the immunological profile and biological risks associated with exosomes’ clinical use according to their cellular origin, addressing persistence, pathogen transmission, delivery routes, and regulatory classification. Furthermore, we highlight the strategic role of blood centers and biobanks in producing high-safety allogeneic sEVs, especially those derived from human platelets and mesenchymal stromal cells expanded in xenofree conditions. While autologous exosomes offer maximal immunological safety, standardized allogeneic strategies free from animal-derived components represent a scalable and regulatory-compatible alternative for modern regenerative therapies.
Keywords: Exosomes, Regenerative Medicine, Autologous Exosomes, Non-autologous Exosomes

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How to Cite this article: Marchant I, Rodríguez B, Pozo V, Parada L, Salvo C, Olivero P | Autologous versus Non-autologous Exosomes: Immunological, Safety, and Regulatory Considerations in Regenerative Medicine | Journal of Regenerative Science | Jan-Jun 2025; 5(1): 31-33.

 

 

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Personalized Multimodal Treatment for Adhesive Capsulitis: A Case Series on Regenerative Medicine and Noninvasive Therapies

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Original Article | Vol 4 | Issue 2 |  July-December 2024 | page: 12-14 | Napoliane Costa Santos, André Vinicius Saueressig Kruel, Alex Pontes de Macedo, Fabio Ramos Costa, Luyddy Pires, Maria Laura Schiefelbein, Palmerindo Antônio Tavares de Mendonça Néto, Renata Takeyama de Oliveira, Daiane Agostini, Jose Fábio Lana

DOI: https://doi.org/10.13107/jrs.2024.v04.i02.145

Author: Napoliane Costa Santos [1], André Vinicius Saueressig Kruel [2], Alex Pontes de Macedo [1], Fabio Ramos Costa [3], Luyddy Pires [1], Maria Laura Schiefelbein [4], Palmerindo Antônio Tavares de Mendonça Néto [5], Renata Takeyama de Oliveira [1], Daiane Agostini [2], Jose Fábio Lana [1]

[1] Department of Orthopedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, SP, Brazil,
[2] Proregen Clínica Médica, Bento Gonçalves, Rio Grande do Sul, Brasil.
[3] TRATE – Traumatologia Esportiva, Salvador, Brazil,
[4] Departamento de Ortopedia, TRATE, Traumatologia Esportiva, Salvador, BA, Brazil, Federal University of Health Science of Porto Alegre, Porto Alegre, Brazil,
[5] Instituto Regenera Dor, Juazeiro do Norte, Ceará, Brazil.

Address of Correspondence
Dr. André Kruel
Proregen Clínica Médica, Bento Gonçalves, Rio Grande do Sul, Brasil.
E-mail: kruel.andre@gmail.com

Abstract

Introduction: Adhesive capsulitis causes chronic shoulder pain and restricted range of motion (ROM). Conventional treatments often offer limited relief, prompting the need for innovative approaches, such as high-intensity pulsed electromagnetic field (PEMF) therapy, shockwave therapy, and orthobiologic injections.

Objective: To evaluate the efficacy of a multimodal approach combining shockwave therapy, high-intensity PEMF therapy, orthobiologic injections, and complementary therapies in improving pain and shoulder function in patients with adhesive capsulitis.

Methods: This retrospective case series included five patients treated in Indaiatuba, São Paulo, Brazil, between May 2023 and October 2024. Individualized multimodal protocols were performed. Pain and ROM were assessed pre- and post-treatment.

Discussion: All patients showed significant improvements in pain and ROM after treatment. High-intensity PEMF therapy, shockwave therapy, and orthobiologics enhanced tissue regeneration, supported by complementary therapies. Personalized protocols optimized outcomes, with synergistic effects observed between treatments.

Conclusion: A multimodal, personalized approach effectively reduced pain and improved function in adhesive capsulitis patients. This strategy shows promise, especially for those unresponsive to conventional treatments, warranting further research.

Keywords: Adhesive capsulitis, High intensity pulsed electromagnetic field therapy, Orthobiologics, Regenerative medicine, Shockwave therapy

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How to Cite this article: Santos NC, Saueressig Kruel AV, de Macedo AP, Costa FR, Pires L, Schiefelbein ML, de Mendonça Néto PAT, de Oliveira RT, Agostini D, Fábio Lana J | Personalized Multimodal Treatment for Adhesive Capsulitis: A Case Series on Regenerative Medicine and Noninvasive Therapies. | Journal of Regenerative Science | July-December 2024; 4(2): 12-17.

 

 

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