Mesenchymal Stem Cell-Derived Exosomes: A Cell-Free Therapeutic Platform for Enhanced Wound Healing and Regenerative Medicine

Chronic and impaired wound healing poses a significant clinical and economic challenge worldwide. Mesenchymal stem cell-derived exosomes (MSC-Exos) have emerged as a highly promising, cell-free therapeutic alternative to traditional cell-based therapies, offering enhanced safety and logistical advantages. These nano-sized extracellular vesicles (۳۰-۱۵۰ nm) are derived from various MSC sources, including adipose tissue, bone marrow, umbilical cord, and amniotic fluid, and are enriched with biologically active cargo such as microRNAs, proteins, and lipids. MSC-Exos orchestrate multiple critical phases of the wound healing cascade by promoting angiogenesis, modulating the immune response toward a pro-regenerative phenotype, stimulating fibroblast and keratinocyte proliferation and migration, enhancing extracellular matrix synthesis and remodeling, and suppressing excessive fibrosis through inhibition of the TGF-β/Smad signaling pathway. Recent advancements in biomaterial science have facilitated the development of exosome-encapsulated hydrogels, which provide sustained local release, improve exosome stability, and significantly enhance wound closure and tissue regeneration in preclinical diabetic and full-thickness wound models. Despite compelling preclinical evidence, the clinical translation of MSC-Exo therapies requires standardized manufacturing protocols, rigorous pharmacokinetic and safety profiling, and validation through randomized controlled trials. This review provides a comprehensive analysis of the current state of MSC-Exo research, detailing their mechanisms of action, delivery strategies, and the prevailing challenges that must be addressed to realize their full therapeutic potential in regenerative wound care.

کلیدواژه ها:

Exosomes ، Mesenchymal Stem Cells ، Wound Healing ، Regenerative Medicine ، Hydrogels ، Cell-Free Therapy