Exosomes and Their Bioengineering Strategies in the Cutaneous Wound Healing and Related Complications: Current Knowledge and Future Perspectives

Abstract

Exosomes, as therapeutically relevant cell-secreted extracellular vesicles, have attracted enormous interest because they participate in intercellular communication and facilitate wound healing. Stem cell-derived exosomes exhibit similar biological effects to source cells with the exception of low immunogenicity and no tumorigenicity, as well as superior efficacy in promoting wound healing. Exosomes accelerate wound healing by promoting angiogenesis and cell proliferation, as well as balancing inflammatory responses. Particularly, when exosomes are genetically modified or used in combination with materials, they can exhibit better comprehensive therapeutic properties, such as enriching active ingredients, targeted delivery, and physiological barrier to penetration, which are not available in traditional single products. Besides, exosomes have also been considered for diagnostic and therapeutic uses related to wounds, such as repairing complex wounds, enhancing graft success, treating related complications, and serving as diagnostic biomarkers. However, their clinical applications still face challenges, as reliable commercial products are not yet available. This review will focus on recent research advances that describe the characteristics and isolation of exosomes, introduce the sources of exosomes suitable for wound repair and related complications, illustrate the value of engineered exosomes and their development directions in the future, and provide evidence for the potential therapeutic application of exosomes in wound healing, as well as discuss potential risks, challenges, and solutions for future applications.

Skin necrosis after intradermal injection of lyophilized exosome: A case report and a review of the literature

“…There is a growing fascination with employing cellular derivatives like exosomes in therapeutic approaches. Nevertheless, further well‐designed long‐term clinical studies are essential to elucidate the immunogenicity, immunotoxicity, biodistribution, persistence, metabolism, excretion, administration route, dosage, concentration, and adverse effects 7,41 . Our case highlights the harmful effects of malpractice and the utilization of unapproved administration methods.…”

Risk factors affecting the sleep quality of patients on dialysis: A single-center cross-sectional study

“…[43] These findings suggest that interventions such as pharmacological treatment, nutrition, hormone modulation, and exercise can effectively enhance the quality of life of patients on dialysis. [44] While this study was focused on sleep quality in patients on dialysis, but there are some limitations that need to be addressed. Firstly, the underlying mechanism of poor sleep quality in these patients remains unclear.…”

Preclinical and Clinical Studies on the Use of Extracellular Vesicles Derived from Mesenchymal Stem Cells in the Treatment of Chronic Wounds

“…Figure shows the most common classification of EVs, which is accepted in many literature contributions. In recent research by Guang Yang et al, EV subunits are classified as follows: 1-Exosomes derived from endosomes (30–150 nm), 2-Microvesicles originating from the plasma membrane (100–1000 nm), 3-Oncosomes released by cancer cells (1000–4000 nm), 4-Apoptotic or pyroptotic bodies produced during programmed cell death (1000–4000 nm), and 5-Migrasomes from migrating cells (500–3000 nm) . Additionally, studies have classified EVs into subpopulations based on surface proteomic analysis or transcriptional profiles. , The classification and naming of EVs can be intricate due to overlapping definitions, prompting the International Society of Extracellular Vesicles (ISEV) to issue recommendations in 2018.…”