Advancements and Insights in Exosome-Based Therapies for Wound Healing: A Comprehensive Systematic Review (2018–June 2023)

Abstract

Exosomes have shown promising potential as a therapeutic approach for wound healing. Nevertheless, the translation from experimental studies to commercially available treatments is still lacking. To assess the current state of research in this field, a systematic review was performed involving studies conducted and published over the past five years. A PubMed search was performed for English-language, full-text available papers published from 2018 to June 2023, focusing on exosomes derived from mammalian sources and their application in wound healing, particularly those involving in vivo assays. Out of 531 results, 148 papers were selected for analysis. The findings revealed that exosome-based treatments improve wound healing by increasing angiogenesis, reepithelization, collagen deposition, and decreasing scar formation. Furthermore, there was significant variability in terms of cell sources and types, biomaterials, and administration routes under investigation, indicating the need for further research in this field. Additionally, a comparative examination encompassing diverse cellular origins, types, administration pathways, or biomaterials is imperative. Furthermore, the predominance of rodent-based animal models raises concerns, as there have been limited advancements towards more complex in vivo models and scale-up assays. These constraints underscore the substantial efforts that remain necessary before attaining commercially viable and extensively applicable therapeutic approaches using exosomes.

Cellular and Molecular Processes in Wound Healing

“…As the use of exosomes as a therapy for wound healing is now clear, Sousa et al [ 79 ], aware of the fact that this therapy has not yet been added to the common treatments, analyzed the substantial efforts that remain necessary before proposing applicable therapeutic approaches using these extracellular vesicles that are produced in the endosomal compartment of most eukaryotic cells.…”

Insight into the Functional Dynamics and Challenges of Exosomes in Pharmaceutical Innovation and Precision Medicine

“…It also aims to analyze the hurdles intrinsic to translating exosome-based therapies from benchtop research to bedside clinical practices [ 7 , 8 ]. The contemporary strategies devised to address the challenges endemic to the therapeutic application of exosomes encompass advancements in research methodologies, data standardization, and the precision characterization of these nanovesicles, alongside innovations aimed at enhancing targeting specificity and cargo delivery efficiency [ 9 ]. It is time to critically explore the emerging techniques for single-exosome analysis and the refinement of surface modification approaches [ 10 , 11 ].…”

Enhancing the wound healing process through local injection of exosomes derived from blood serum: An in vitro and in vivo assessment

“…In the proliferation phase, exosomes aid in wound closure by activating endothelial cells and fibroblasts, thereby promoting angiogenesis and initiating extracellular matrix deposition [ 1 , 9 ]. During the remodeling phase, exosomes regulate the balance between matrix metalloproteinases and tissue inhibitors of matrix metalloproteinases, leading to favorable wound healing outcomes [ 1 , 10 ]. While exosomes have demonstrated effects on adipogenesis, immune cells, and various physiological and molecular pathways, their role in wound healing has been well-established.…”