The role of bacterial extracellular vesicles in chronic wound infections: Current knowledge and future challenges

Abstract

Chronic wounds are a significant global problem with an increasing economic and patient welfare impact. How wounds move from an acute to chronic, non-healing, state is not well understood although it is likely that it is driven by a poorly regulated local inflammatory state. Opportunistic pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa are well known to stimulate a pro-inflammatory response and so their presence may further drive chronicity. Studies have demonstrated that host cell extracellular vesicles (hEVs), in particular exosomes, have multiple roles in both increasing and decreasing chronicity within wounds; however, the role of bacterial extracellular vesicles (bEVs) is still poorly understood. The aim of this review is to evaluate bEV biogenesis and function within chronic wound relevant bacterial species to determine what, if any, role bEVs may have in driving wound chronicity. We determine that bEVs drive chronicity by both increasing persistence of key pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa and stimulating a pro-inflammatory response by the host. Data also suggest that both bEVs and hEVs show therapeutic promise, providing vaccine candidates, decoy targets for bacterial toxins or modulating the bacterial species within chronic wound biofilms. Caution should, however, be used when interpreting findings to date as the bEV field is still in its infancy and as such lacks consistency in bEV isolation and characterization. It is of primary importance that this is addressed, allowing meaningful conclusions to be drawn and increasing reproducibility within the field.

Nanoarchitectonics-based electrochemical aptasensors for highly efficient exosome detection

“…The extracellular assay in the lipid bilayer, including phosphoglycerides with long and saturated fatty-acyl chains, cholesterol, and sphingolipids, ceramides [ 49 ], saccharide chains, lactadherin and membrane transport and fusion proteins, serve as signals for specific cell receptors, facilitating intricate cellular communication between target cells and exosomes [ 50 ]. Initially discovered in 1981 as vesicles eliminating obsolete proteins [ 51 , 52 ], their primary role is now recognised as transport carriers actively participating in cell–cell communication, providing insights into intracellular and extracellular biological molecules [ 53 ]. For those seeking in-depth and current information on exosomes, resources like Vesiclepedia and ExoCarta provide up-to-date and comprehensive insights [ 54 ].…”

Emerging Effects of Resveratrol on Wound Healing: A Comprehensive Review

“…Avoiding local wound infections in the early stages of tissue damage is an essential part of early treatment. Most common clinical infections are bacterial and fungal, with S. aureus , P. aeruginosa and C. albicans predominating [ 65 ]. Therefore, the use of antimicrobial agents is essential in the early treatment of the tissue repair process.…”

Exosomes as Powerful Engines in Cancer: Isolation, Characterization and Detection Techniques

“…Exosomes are endosome-derived membrane vesicles with a size range of 20–150 nm [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ] and are derived naturally from nearly all cell types [ 1 , 13 , 14 , 15 ]. When exosomes were first discovered in 1981 in mammalian cells, they were believed to act as discharged vesicles of obsolete molecules [ 16 , 17 ]. After their roles in communication were revealed, they were thought to communicate only within one species, but they were later found to engage in interkingdom communication [ 10 ].…”