A case report on nebulized human umbilical cord mesenchymal stem cell-derived exosome therapy for asthma and chronic obstructive pulmonary disease: A preliminary clinical evaluation

Human umbilical cord mesenchymal stem cell-derived exosomes have gained attention as a promising, cell-free regenerative therapy due to their immunomodulatory and tissue-repair properties. This study retrospectively evaluated the safety and efficacy of nebulized human umbilical cord mesenchymal stem cell exosome therapy in three patients with asthma and/or chronic obstructive pulmonary disease who underwent weekly nebulized exosome therapy for 5 weeks at ALPS Medical Centre, Kuala Lumpur, Malaysia. Clinical outcomes were assessed using pulmonary function tests, inflammatory markers, and laboratory parameters. Post-therapy, pulmonary function improved, with increases in forced expiratory volume in 1 s from 2.59 to 3.4 L ( p = 0.07) and forced vital capacity from 2.48 to 3.32 L ( p = 0.11), while the forced expiratory volume in 1 s/forced vital capacity ratio significantly increased from 82.57% to 92.9% ( p = 0.05), indicating reduced airflow limitation. Inflammatory markers, including C-reactive protein and eosinophil count, remained stable, and no significant changes were observed in hepatic, renal, or haematological parameters. Additionally, no adverse reactions or safety concerns were reported. In conclusion, nebulized human umbilical cord mesenchymal stem cell-derived exosome therapy demonstrated potential in improving pulmonary function and alleviating respiratory symptoms in patients with asthma and chronic obstructive pulmonary disease while maintaining a favourable safety profile. These preliminary findings support further investigation of exosome therapy as an adjunctive treatment for chronic respiratory diseases.