The effectiveness of cell-derived exosome therapy for diabetic wound: A systematic review and meta-analysis

Qiao, Zhihua; Wang, Xiancheng; Zhao, Hongli; Deng, Yiwen; Zeng, Weiliang; Yang, Kai; Chen, Hui; Yan, Quanding; Li, Chunjie; Wu, Jingjing; Chen, Yunzhu

doi:10.1016/j.arr.2023.101858

Cited by 15 publications

(10 citation statements)

References 64 publications

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“…Treatment of HUVECs with different concentrations of EVs exerted significant effects on the cells, including the promotion of cell migration and tube formation in a dose-dependent manner (Figs. S6 and S7 ), consistent with previous reports on the strong biological activity of EVs [ 30 , 31 ].…”

Section: Resultssupporting

confidence: 92%

Microenvironment Remodeling Self-Healing Hydrogel for Promoting Flap Survival

Ju,

Yang,

Liu

et al. 2024

Biomater Res

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Random flap grafting is a routine procedure used in plastic and reconstructive surgery to repair and reconstruct large tissue defects. Flap necrosis is primarily caused by ischemia–reperfusion injury and inadequate blood supply to the distal flap. Ischemia–reperfusion injury leads to the production of excessive reactive oxygen species, creating a pathological microenvironment that impairs cellular function and angiogenesis. In this study, we developed a microenvironment remodeling self-healing hydrogel [laminarin–chitosan-based hydrogel-loaded extracellular vesicles and ceria nanozymes (LCH@EVs&CNZs)] to improve the flap microenvironment and synergistically promote flap regeneration and survival. The natural self-healing hydrogel (LCH) was created by the oxidation laminarin and carboxymethylated chitosan via a Schiff base reaction. We loaded this hydrogel with CNZs and EVs. CNZs are a class of nanomaterials with enzymatic activity known for their strong scavenging capacity for reactive oxygen species, thus alleviating oxidative stress. EVs are cell-secreted vesicular structures containing thousands of bioactive substances that can promote cell proliferation, migration, differentiation, and angiogenesis. The constructed LCH@EVs&CNZs demonstrated a robust capacity for scavenging excess reactive oxygen species, thereby conferring cellular protection in oxidative stress environments. Moreover, these constructs notably enhance cell migration and angiogenesis. Our results demonstrate that LCH@EVs&CNZs effectively remodel the pathological skin flap microenvironment and marked improve flap survival. This approach introduces a new therapeutic strategy combining microenvironmental remodeling with EV therapy, which holds promise for promoting flap survival.

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Section: Resultssupporting

confidence: 92%

Microenvironment Remodeling Self-Healing Hydrogel for Promoting Flap Survival

Ju,

Yang,

Liu

et al. 2024

Biomater Res

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“…Bigger, more homogeneous samples are mandatory for this examination. This was also emphasised in preceding studies that employed a linked meta‐analysis technique and found equivalent consequences of the influence 44‐48 …”

Section: Discussionmentioning

confidence: 81%

“…This was also emphasised in preceding studies that employed a linked metaanalysis technique and found equivalent consequences of the influence. [44][45][46][47][48] Well-led Randomised preclinical trials are necessary to weigh these features as well as the blend of diverse ethnicities, ages and other parameters of subjects since the meta-analysis could not define whether differences in them are linked to the outcomes studied. In conclusion, subjects with surgical instrumentation in their surgery had a significantly higher rate of POSSWPs in STS compared with those without surgical instrumentation.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for postoperative surgical site wound problems after metastatic and primary spine tumour surgery: A meta‐analysis

Zhu

Huang

2023

International Wound Journal

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A meta‐analysis study was conducted to assess the risk factors (RFs) for postoperative surgical site wound problems (POSSWPs) after metastatic and primary spine tumour surgery (STS). A comprehensive literature examination until February 2023 was implemented, and 1786 linked studies were appraised. The 18 picked studies contained 18 580 subjects with surgery in the studies' baseline with and without different RFs. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to calculate the consequence of RFs for POSSWPs after metastatic and primary STS using the dichotomous and continuous styles and a fixed or random model. Subjects with surgical instrumentation in their surgery had a significantly higher rate of POSSWPs in STS (OR, 2.28; 95% CI, 1.49–3.49, P < 0.001) compared with those without surgical instrumentation. Subjects with preoperative chemotherapy had a significantly higher rate of POSSWPs in STS (OR, 1.81; 95% CI, 1.09–3.00, P = 0.02) compared with those without preoperative chemotherapy. Subjects with preoperative radiotherapy had a significantly higher rate of POSSWPs in STS (OR, 1.93; 95% CI, 1.12–3.34, P = 0.02) compared with those without preoperative radiotherapy. Subjects with corticosteroid intake had a significantly higher rate of POSSWPs in STS (OR, 2.89; 95% CI, 1.73–4.82, P < 0.001) compared with those without corticosteroid intake. No significant difference was found between males and females in the rate of POSSWPs in STS (OR, 0.95; 95% CI, 0.66–1.37, P = 0.78). Surgical instrumentation, preoperative chemotherapy, preoperative radiotherapy and corticosteroid are RFs for the higher rate of POSSWPs in STS; however, gender was not shown to be a risk factor. Though precautions should be taken when commerce with the consequences since some of the studies picked for this meta‐analysis had low sample sizes.

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“…Bigger, more homogeneous samples are mandatory for this examination. This was also emphasised in preceding studies that used a linked meta‐analysis technique and found equivalent consequences of the influence 49,72,73 …”

Section: Discussionmentioning

confidence: 82%

“…This was also emphasised in preceding studies that used a linked meta-analysis technique and found equivalent consequences of the influence. 49,72,73 Well-led Randomised preclinical trials are necessary to weigh these features as well as the blend of diverse ethnicities, ages, gender, and other parameters of animal models because the meta-analysis could not define whether differences in them are linked to the outcomes studied. In conclusion, MSC-EVs had a significantly higher rate of wound closure of DWs, lower width of the scar, higher collagen deposition, and higher rate of reepithelialisation compared with the control.…”

Section: Discussionmentioning

confidence: 99%

Effect of mesenchymal stromal cells‐derived extracellular vesicles as a treatment to heal diabetic wounds: A meta‐analysis

Chang

2023

International Wound Journal

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A meta‐analysis study to assess the influence of mesenchymal stromal cells‐derived extracellular vesicles (MSC‐EVs) as a treatment to heal the diabetic wound (DW). A comprehensive literature examination till February 2023 was implemented and 2975 linked studies were appraised. The picked studies contained 381 animals with diabetes mellitus in the picked studies' baseline, 217 of them were using MSC‐EVs, and 173 were using control. Odds ratio in addition to 95% confidence intervals (CIs) were used to calculate the consequence of MSC‐EVs as a therapy to heal DWs by the dichotomous and continuous styles and a fixed or random model. MSCs‐EVs had a significantly higher rate of wound closure of DWs (Mean deviation [MD], 22.20; 95% CI, 19.16–25.24, P < .001), lower width of the scar (MD, −2.57; 95% CI, −3.35 to −1.79, P < .001), higher collagen deposition (MD, 30.82; 95% CI, 20.77–40.86, P < .001), and a higher rate of re‐epithelialisation (MD, 34.36; 95% CI, 20.13–48.58, P < .001) compared with the control. MSCs‐EVs had a significantly higher rate of wound closure of DWs, lower width of the scar, higher collagen deposition, and higher rate of re‐ epithelialisation compared with the control. Although precautions should be taken when commerce with the consequences because all of the picked studies for this meta‐analysis was with low sample sizes.

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The effectiveness of cell-derived exosome therapy for diabetic wound: A systematic review and meta-analysis

Cited by 15 publications

References 64 publications

Microenvironment Remodeling Self-Healing Hydrogel for Promoting Flap Survival

Microenvironment Remodeling Self-Healing Hydrogel for Promoting Flap Survival

Risk factors for postoperative surgical site wound problems after metastatic and primary spine tumour surgery: A meta‐analysis

Effect of mesenchymal stromal cells‐derived extracellular vesicles as a treatment to heal diabetic wounds: A meta‐analysis

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