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The 2024 Nobel Prize in Physiology or Medicine was recently awarded to American scientists Victor Ambros and Gary Ruvkun for their groundbreaking discovery of microRNA (miRNA). Among the plethora of medical applications, this is a significant breakthrough in aesthetic medicine, explains Dr Debbie Norval. After all, exosomes – which are making serious waves in aesthetics – are extracellular vesicles filled with miRNA.
At their very core, and put as simply as possible, these tiny RNA molecules help control how genes work in our bodies. More specifically, miRNA regulates gene expression – a process that uses the information contained within a gene to produce proteins that carry out vital functions. Naturally, this is critical to the development and functioning of living organisms.
The research carried out by Ambros and Ruvkun paves the way for innovative medical applications, particularly in developing treatments for diseases like cancer, where miRNA will be used to help regulate overactive genes or serve as valuable biomarkers for diagnosis.
This phenomenal work is shaping history and changing our lives forever.

The Nobel Prize: A brief history
Before delving deeper into miRNA, let’s go back in history to appreciate the significance of the Nobel Prize, established in 1895 by Alfred Nobel. It is undoubtedly the most prestigious award in the world, honouring groundbreaking achievements that benefit humanity. Every year, the Nobel Prize recognises exceptional work in six categories: Peace, Literature, Chemistry, Physics, Physiology or Medicine, and Economic Sciences.
Winning a Nobel Prize means that a scientist can place their name alongside legends like Albert Einstein for his work on photoelectricity, Marie Curie for her breakthroughs in radiation therapy, and Alexander Fleming for discovering the very first antibiotic, penicillin. Watson and Crick won the Nobel Prize for discovering the double helix structure of DNA back in 1962.
This year, with miRNA technology in the spotlight, is especially exciting for aesthetic medicine, and exosome technology, and is validating for doctors who have embraced the potential of epigenetics in regenerative medicine.
RNA in the spotlight… again!
Believe it or not, but 2024 is not the first time a Nobel Prize has been awarded for work on RNA: in 1968, scientists were awarded the prize for deciphering the genetic code and transfer RNA’s role in protein synthesis; in 1989, for discovering RNA’s catalytic function; and, in 2006, for work on RNA interference, which silences gene expression.
Last year, Karikó and Weissman won the Nobel Prize for their groundbreaking work on messenger RNA (mRNA), which they had been researching for years before the COVID-19 pandemic hit the world. This important discovery paved the way for mRNA vaccines, and is the reason that companies like Pfizer-BioNTech and Moderna were able to create COVID-19 vaccines so quickly.
Nucleotides 101: Understanding DNA and RNA
At this point, you may be scratching your head, trying to remember school biology and the difference between DNA and RNA. We all know they are part of our genetic material, but what are they exactly? And what’s with all the different types of RNA? Let’s take a look.

DNA and RNA are essential molecules that carry genetic information but differ significantly in their structure and function. DNA, or deoxyribonucleic acid, is a long, double-stranded molecule forming the classic double helix we all associate with images of our chromosomes. DNA is found within the nucleus of our cells and serves as the long-term storage of genetic instructions necessary for growth, development, and functioning. In essence, DNA is our “blueprint” for building proteins.
In contrast, RNA, or ribonucleic acid, is a single strand and is typically shorter. It functions as a messenger, transferring instructions from DNA to the cell’s protein-making factories, called ribosomes. RNA comes in various forms, such as mRNA, which carries these instructions, and miRNA, which helps regulate gene expression. RNA can be found in the nucleus, the cytoplasm, and in the extracellular space, as in the case of exosomes.
In simple terms, DNA holds our genetic information like a permanent instruction manual, while RNA works as a temporary helper, carrying out the instructions from DNA to make proteins.

The different types of RNA
Unlike DNA, there are around 20 different types of RNA. Examples include messenger RNA (mRNA), transfer RNA (tRNA), ribosomal RNA (rRNA), and microRNA (miRNA). Some RNAs are coding molecules, which means they code for protein synthesis, while others are non-coding and regulate gene expression. Non-coding RNAs, like miRNA, are non-species-specific.
Let’s look more closely at miRNA, and how it differs from the more widely recognised mRNA. Both mRNA and miRNA are involved in gene expression but serve different functions:
- mRNA is a large coding RNA molecule that transmits genetic instructions from DNA to the protein-making ribosome, where these instructions act as templates for protein synthesis. This makes mRNA essential for direct protein production.
- miRNA, on the other hand, is a small, non-coding RNA molecule, typically around 22 nucleotides long. It regulates gene expression by binding to complementary sequences on mRNA molecules. Once bound, miRNA can either break down the mRNA or block its ability to produce proteins.
In essence, mRNA gives the instructions for protein creation, while miRNA functions as a regulator, determining the quantity of protein produced through its interactions with mRNA.
miRNAs play a crucial role in epigenetics, which refers to subsequent changes in gene expression that occur without changing the underlying DNA code. Although miRNAs can’t change our DNA sequence, they can influence gene expression by regulating mRNA. This regulatory function is essential for maintaining cellular balance.
What’s the link between miRNA and exosomes?
The latest buzzword in aesthetic and regenerative medicine, exosomes are tiny extracellular vesicles secreted by cells, with a double-layered lipid membrane, encapsulating a cargo of essential bioactive molecules including DNA and RNA.
Exosomes are vital for cell-to-cell communication. Exosomes that are secreted by stem cells have incredible regenerative and anti-inflammatory properties.
It’s the miRNA in these exosomes that is currently in the spotlight!
miRNA is an essential component of exosomes, and its discovery holds exciting potential for aesthetic and regenerative treatments.

The exosome cargo
As we know, exosomes carry precious miRNA. But there are a lot of other fascinating molecules inside the exosome too, each playing an important role in cell-to-cell communication.
Exosomes carry proteins, including enzymes and signalling molecules, that can affect how recipient cells function. Many of these proteins are growth factors, which are essential for cell growth, healing, and regeneration. Examples of growth factors found in exosomes include fibroblast growth factor and epidermal growth factor.
Lipids are a vital component of exosomes, mainly found in the lipid bilayer membrane that protects their contents. Inside the exosome, lipid molecules such as cholesterol and ceramides play a role in barrier repair in target cells.
Besides miRNA, exosomes carry other genetic material such as DNA, other non-coding RNAs, and mRNAs involved in protein synthesis.
The exciting potential of exosomes in aesthetic medicine
Doctors have been using growth factors in aesthetic medicine for many years. While exosomes also carry growth factors, their ability to transport miRNA sets them apart as powerful tools in regenerative therapies.
Growth factors stimulate cell growth and tissue repair, while miRNAs provide an additional layer of control by directly influencing the genetic machinery of cells. This epigenetic effect allows for more targeted and sustained effects.
miRNAs in exosomes reduce inflammation, regulate collagen production, and stimulate cellular regeneration. Since miRNAs regulate gene expression, they offer a more long-lasting impact compared to growth factors, which tend to act more immediately but lack the long-term genetic modulation that miRNAs provide.
Best of all is that exosomes don’t have to be injected. It is protocol to apply exosomes as a topical serum during and after treatments like Dermapen® microneedling, RF microneedling, fractional laser, and Tixel®. Some of the applications in aesthetic medicine include skin, hair and vaginal rejuvenation, pigmentation, acne, wound healing, and scars.
The non-species-specific nature of miRNA and the use of plant-based exosomes
Some of my colleagues have expressed, “I’m not a rose or a fish! I’ll only use human exosomes!”
However, miRNAs are classified as non-coding RNAs, meaning they don’t code for protein synthesis. Instead, they bind to complementary sequences on target mRNAs, regulating protein production. Importantly, miRNAs recognise short, conserved sequences of nucleotides common across many organisms, allowing the same miRNA to regulate similar biological pathways in vastly different species, from plants to animals, without being limited to a specific genetic code.
The flexibility of miRNA allows for the use of natural sources, such as plants, in human therapies without the need for genetic compatibility.
Because miRNAs only require a complementary sequence of about 6–8 nucleotides to operate, they can function across different species, influencing various biological processes, such as cell growth, differentiation, and repair.
The cross-species functionality of miRNA is particularly beneficial in aesthetic and regenerative medicine. For instance, plant-derived exosomes from sources like Centella asiatica or rose stem cells can be used without concerns about species specificity or the legal and ethical restrictions surrounding human stem cell exosomes. Companies like DermapenWorld® are now incorporating plant-based CICA® exosomes into their products, while ExoCoBio® offers a pure rose exosome product.
Bioengineered exosomes
Can exosomes be artificially created or bioengineered?
Natural exosomes act as nanocarriers in the body, and biotechnology has advanced to the point where bioengineered exosome-like nanovesicles (referred to as exosome mimetics) can be created. These synthetic exosomes mimic the properties of natural exosomes – such as size, structure, and content – but are not identical to their natural counterparts. That said, they are similar in that they carry growth factors, proteins, lipids, and plant-based miRNA.
Nanoencapsulation technology allows scientists to design and produce exosome technology with specific therapeutic properties, with the targeted delivery of drugs, RNA therapies, and gene editing tools.
Like plant-derived exosomes, bioengineered exosome products bypass the legal and ethical restrictions placed on human stem cell products.
Human Stem cell therapy in South Africa
In South Africa, it is legal for individuals to store their own stem cells in a stem cell bank for future personal medical purposes. However, for ethical reasons, the regulations surrounding human stem cell therapy from donor sources, or the use of exosomes secreted by human stem cells, are much more restrictive.
In South Africa, exosome products derived from human stem cells are not legal. However, plant-derived and biomimetic exosome products provide an excellent alternative. These exosomes have the same beneficial effects as human exosomes, such as promoting tissue repair and reducing inflammation, without the legal, ethical, and regulatory concerns associated with human stem cell therapies.
It’s not just South Africa. Globally, human stem cell therapies face similar legal restrictions in most countries, with a few exceptions, like South Korea, Japan, and Mexico.
By using plant and biomimetic exosomes, practitioners in South Africa can still offer advanced regenerative treatments while upholding the law and respecting SAHPRA regulations.
Human stem cell derived exosomes from Wharton’s jelly, placenta, or bone marrow are likely illegally imported, unregulated, unlicensed, and should be avoided.
Conclusion
The Nobel Prize-winning discovery of miRNA by Ambros and Ruvkun has transformed our understanding of gene regulation, presenting new and fascinating possibilities for aesthetics and regenerative medicine. The revelation that exosomes carry the mighty miRNA unlocks new avenues for regeneration, renewal, and healing.
As we continue to explore the potential of miRNA and exosome therapy, the future of aesthetic medicine promises significant advancements in skin health, hair restoration, healing, and scar management. We truly are living in exciting times and the journey ahead is filled with potential.
MBBCh (Rand) Dip Pall Med (cUK) M Phil Pall Med (UCT) Adv Dip Aesthetic Med (FPD)
Dr Debbie Norval graduated as a medical doctor from the University of the Witwatersrand, in 1991. Post graduate training includes a Diploma in Palliative Medicine through the University of Wales, Masters of Philosophy from the University of Cape Town, an Advanced Diploma in Aesthetic Medicine through the Foundation for Professional Development and a City and Guilds Diploma in Adult Teaching and Training.
Dr Norval is the convenor of the Johannesburg Aesthetic Doctors Journal Club and sits on the scientific committee of the Aesthetic Medicine Congress of South Africa (AMCSA). She is the Past President of the Aesthetic and Anti-Aging Medicine Society of South Africa (AAMSSA) and serves on the International Advisory Board of CMAC (Complications in Medical Aesthetics Collaborative).
“Dr Debbie Norval Aesthetics” is a busy clinical practice in Parktown North, Johannesburg.
Please note Dr Debbie is not taking on new patients at this time.