Mesenchymal stem cells (MSCs) have shown tremendous promise in regenerative medicine due to their regenerative, immunomodulatory, and pro-angiogenic properties. More recently, the focus has shifted towards the paracrine effects of MSCs, particularly the role of their secreted exosomes in tissue repair and regeneration.
Exosomes are nanosized extracellular vesicles that carry a cargo of proteins, nucleic acids, and lipids capable of modulating the microenvironment and promoting tissue healing. This review discusses the latest advancements in utilizing MSC-derived exosomes as a cell-free therapy for advanced wound care. The unique advantages of exosomes, including their small size, stability, and low immunogenicity, make them attractive candidates for targeted delivery and personalized medicine applications. MSC-derived exosomes have been shown to exert immunomodulatory effects by regulating inflammatory responses and promoting a shift towards a pro-regenerative microenvironment. Furthermore, their ability to stimulate angiogenesis, fibroblast proliferation, and collagen synthesis has been demonstrated in various preclinical wound models. Recent studies have also explored the incorporation of therapeutic cargoes into exosomes to enhance their regenerative potential, such as small interfering RNA (siRNA) or microRNAs. Clinical trials investigating the efficacy of MSC-derived exosomes in chronic wounds, burns, and tissue defects have shown promising results, with accelerated wound closure, reduced scarring, and improved functional outcomes. Challenges remain in terms of standardizing isolation and characterization techniques, optimizing dosing regimens, and ensuring long-term safety. Future directions include the development of engineered exosomes with enhanced therapeutic properties and the exploration of combinatorial approaches with biomaterials or growth factors to further augment wound healing outcomes. Overall, the application of MSC-derived exosomes in wound care represents a cutting-edge strategy with exciting potential for revolutionizing regenerative medicine.
