Xiao and coworkers reported that exosomal thrombospondin-1 (THBS1) secreted by oral squamous cell carcinoma cells can activate M1 macrophages polarization to promote malignant migration.65 Notably, exosomes can induce activation of M2 macrophages thus inhibiting inflammatory response, leading to abrogation of many diseases.66,67 Studies reported that exosomes from mesenchymal stem cells (MSCs) ameliorate cardiac damage in myocardial infarction rats and ischemia/reperfusion mice by activating macrophage M2 polarization.68,69 However, M2 macrophages polarization can be detrimental. The gene discussed is THBS1; the disease is squamous cell carcinoma.