Moreover, cells under stress are reported to increase their exosome production impacting on several different pathways, BMSC-derived exosomes influence the activation of several survival pathways, such as c-Jun N-terminal kinase, p38, p53, and Akt, as well as promote the migration of MM cells through the up-regulation of CXCL12/CXCR4/monocyte chemoattractant protein-1 (MCP-1) axis [68]. This evidence concerns the gene CXCR4 and Miyoshi myopathy.