Current understanding of the mesenchymal stem cell-derived exosomes in cancer and aging

•Mesenchymal stem cell (MSC) exosomes are nano-sized lipid bilayer vesicles used as drug delivery vehicles.•MSC-exosomes perform an indispensable role in the probable cell-free therapies for various diseases.•The precise mechanism of exosome internalization may highlight the translational therapeutic strategies.•MSC-exosomes possess unique potentials to treat cancer, aging related disorders and in regeneration of tissues.•Exosomes may be considered as valid diagnostic biomarkers and potential future therapeutic tools. Mesenchymal stem cells (MSCs) are being widely researched upon for several years with translational application in regenerative medicine. Many studies acknowledged trophic factors from MSCs, attenuating dreadful ailments. The beneficial properties of MSCs are attributed to their secretion of paracrine factors as extracellular vesicles/ exosomes in the tissue microenvironment. Exosomes are nano-sized vesicles involved in genetic material transportation and intercellular communication. Exosomes have been recently reported to play a role in cell-free therapy in treating many diseases like cancer and aging and are reported in regulating tumor cell fate. This review highlights the recent advances and current understanding in assessing mesenchymal stem cell-derived exosomes for possible cell-free therapy. The sources and composition of exosomes, drug delivery effectiveness, immunomodulatory property, therapeutic advances in cancer, and aging targeting exosomes as cargo or its effect to moderate the tissue microenvironment are also discussed. We summarize the regenerative mechanisms induced by MSCs derived exosomes. Graphical abstract: Mesenchymal stem cell derived exosomes. The figure displays the current procurement sources and strategies involved for enrichment of exosomes from mesenchymal stem cells (MSC). It also lists the major constituents of MSC exosomes, the application of the exosomes for various ailments and the possible challenges faced in exosome research. [Display omitted]