On 23 and 24 October I attended the 4th Annual Regenerative Medicine ASRM Congress at the JW Marriott Marina in Dubai. The programme covered cellular therapy, exosomes, gene editing and the use of AI in treatment planning.1 I came back with one topic on my mind more than any other, and I would like to share how I am thinking about it.
There was a heavy emphasis on Muse cells, and some of the discussions were heated. I think that is healthy: a field that cannot argue openly about its evidence is not ready to offer treatments to patients. Here is where I stand, and why.
Muse cells in one paragraph
Muse cells are a small subpopulation found within mesenchymal stem cell (MSC) cultures. In laboratory and animal studies they appear to home to damaged tissue and integrate into it more effectively than ordinary MSCs. I have set out the evidence in detail in Muse Cells vs Mesenchymal Stem Cells: What the Evidence Actually Shows. This article is about a different question: what I think matters most when a treatment is described as stronger.
How I use mesenchymal cells, and why it shapes my view
When I use mesenchymal stem cells, I do not depend on the cells homing to the tissue or staying there. I am relying on their paracrine signalling, the cytokines, growth factors and extracellular vesicles they release, which calm inflammation and prompt the body’s own repair. The patient has the treatment and goes home.
That fits what is known about their biodistribution. After an intravenous infusion, most cells are first trapped in the lungs and few appear to engraft long term.2 It also fits their safety record: an updated systematic review of randomised trials of intravascular MSCs found no signal for malignancy, with transient fever the main consistent association.3
When a cell is meant to home, the safety question changes
The argument for Muse cells is that they do something MSCs mostly do not. In animal models they have been reported to migrate towards damaged tissue by sensing a distress signal, sphingosine-1-phosphate, and to integrate into it.4 Whether that happens in people, and how often, is not yet known.
That is why I frame the question in terms of evidence rather than alarm. A cell that is meant to find damaged tissue, persist and differentiate needs a different kind of evidence from one that acts by signalling and clears: where the cells go, how long they last, and what happens over years of follow-up. I am not saying Muse cells cause cancer, and persistence is not in itself a danger. I am saying that a property which may make a treatment stronger raises the evidentiary burden and calls for long-term surveillance, and we do not have that data yet.
Life-threatening disease and healthy longevity are different decisions
Bone marrow aspiration and transplantation are accepted for patients with cancer and other life-threatening conditions. They carry real risks, and those patients accept them because the disease is worse. The same logic applies when a stem cell treatment is a last realistic option for someone who is seriously ill: a powerful and less well-characterised intervention can be worth the risk.
A healthy person who wants to age well is in a different position. The potential benefit is smaller and harder to measure, and the risk falls on someone who did not need treatment. So the question I kept returning to at the congress was this: for healthy people seeking longevity, are these cells worth the risk?
As far as I know, there are no human trials of Muse cells in healthy people or for ageing. The human safety follow-up that does exist is short: up to about 52 weeks in the stroke trial and 18 months in the neonatal trial.5,6 A treatment described as stronger deserves stronger evidence, particularly when the person receiving it is well.
What I would want to see before using them for longevity
- Biodistribution: where do the administered cells actually go?
- Persistence: how long are they detectable in the body?
- Long-term tumour surveillance: not because tumour formation has been shown, but because long-lived or differentiating cellular therapies need long observation.
- Controlled human efficacy data: not only case reports or mechanistic plausibility, and ideally a head-to-head comparison with conventional MSCs.
- Long-term follow-up in the intended population: especially healthy people seeking longevity, rather than extrapolation from stroke, heart attack or other serious disease.
Questions to ask any clinic offering cell therapy
- Which cells will I receive, and from what source?
- What human evidence exists for that exact product?
- How long have patients been followed, and what was found?
- What is the plan if I have a reaction or a complication?
- Is this treatment being offered for a disease, or for longevity in a healthy person, and does the evidence match that purpose?
I put the same questions to my own practice.
Where I stand
In my own practice, I currently work with MSC-based therapies and selected exosome-based approaches. I regard them as evolving areas of medicine, not as settled science. I will keep following the Muse cell research with interest, and I will revise my view if well-designed human studies show benefit together with long-term safety.
Novel does not mean unsafe. But novel also does not mean proven.
Thinking about cell therapy?
If you are considering stem cell or exosome therapy and want an honest view of which cells, what the evidence shows and whether it is right for you, send me a message. WhatsApp +971 52 328 6185.
Frequently asked questions
Muse cells are a small subpopulation found within mesenchymal stem cell cultures, identified by the surface marker SSEA-3. In laboratory and animal studies they appear to home to damaged tissue and integrate into it more effectively than ordinary MSCs.4
Some do, but inefficiently. After an intravenous infusion most cells are first trapped in the lungs and very few engraft, which is why their benefit is thought to come mainly from paracrine signalling.2
Early studies of one product in small numbers of patients reported the treatment as generally tolerated, and one randomised trial recorded a serious neurological event in the treated group. Follow-up was at most about 18 months and the numbers were small, so long-term safety, including the risk of late events such as tumours, has not been established.5,6
In a life-threatening disease a patient may reasonably accept a serious risk because the alternative is worse. A healthy person seeking longevity has less to gain and more to lose, so I think the evidence required should be higher.
In my own practice, I currently work with MSC-based therapies and selected exosome-based approaches. I regard them as evolving areas of medicine, not as settled science. I follow the Muse cell research and will revise my view if good-quality human studies show benefit together with long-term safety.
Start with a conversation.
Tell me what you are hoping to achieve and I will give you my honest view on whether cell therapy is appropriate for you, and which type. WhatsApp +971 52 328 6185.
About the author. Dr Shiva Faramarzi, MD, is an aesthetic, regenerative and longevity physician at Apogee Clinic, JBR, Dubai (DHA licence 43705219). This article is patient education and does not replace the advice of your own doctor.
References
1. Regenerative Medicine ASRM Congress 2026 (4th Annual), 23-24 October 2026, JW Marriott Marina, Dubai. Event listing, Edarabia. https://www.edarabia.com/?p=390013 (accessed 28 October 2026)
2. Leibacher J, Henschler R. Biodistribution, migration and homing of systemically applied mesenchymal stem/stromal cells. Stem Cell Res Ther. 2016;7:7.
3. Thompson M, Mei SHJ, Wolfe D, et al. Cell therapy with intravascular administration of mesenchymal stromal cells continues to appear safe: an updated systematic review and meta-analysis. EClinicalMedicine. 2020;19:100249.
4. Dezawa M. Macrophage- and pluripotent-like reparative Muse cells are unique endogenous stem cells distinct from other somatic stem cells. Front Bioeng Biotechnol. 2025;13:1553382.
5. Niizuma K, Osawa SI, Endo H, et al. Randomized placebo-controlled trial of CL2020, an allogenic Muse cell-based product, in subacute ischemic stroke. J Cereb Blood Flow Metab. 2023;43(12):2029-2039.
6. Sato Y, et al. Safety and tolerability of a Muse cell-based product in neonatal hypoxic-ischemic encephalopathy with therapeutic hypothermia (SHIELD trial). Stem Cells Transl Med. 2024;13(11):1053-1066.
2. Leibacher J, Henschler R. Biodistribution, migration and homing of systemically applied mesenchymal stem/stromal cells. Stem Cell Res Ther. 2016;7:7.
3. Thompson M, Mei SHJ, Wolfe D, et al. Cell therapy with intravascular administration of mesenchymal stromal cells continues to appear safe: an updated systematic review and meta-analysis. EClinicalMedicine. 2020;19:100249.
4. Dezawa M. Macrophage- and pluripotent-like reparative Muse cells are unique endogenous stem cells distinct from other somatic stem cells. Front Bioeng Biotechnol. 2025;13:1553382.
5. Niizuma K, Osawa SI, Endo H, et al. Randomized placebo-controlled trial of CL2020, an allogenic Muse cell-based product, in subacute ischemic stroke. J Cereb Blood Flow Metab. 2023;43(12):2029-2039.
6. Sato Y, et al. Safety and tolerability of a Muse cell-based product in neonatal hypoxic-ischemic encephalopathy with therapeutic hypothermia (SHIELD trial). Stem Cells Transl Med. 2024;13(11):1053-1066.
This article is part of my guide to regenerative medicine in Dubai. If you are considering treatment, read how I assess stem cell therapy in Dubai.
