Insights into optimizing exosome therapies for acute skin wound healing and other tissue repair

Abstract

Exosome therapy holds great promise as a novel approach to improve acute skin wound healing. This review provides a comprehensive overview of the current understanding of exosome biology and its potential applications in acute skin wound healing and beyond. Exosomes, small extracellular vesicles secreted by various stem cells, have emerged as potent mediators of intercellular communication and tissue repair. One advantage of exosome therapy is its ability to avoid potential risks associated with stem cell therapy, such as immune rejection or stem cells differentiating into unwanted cell types. However, further research is necessary to optimize exosome therapy, not only in the areas of exosome isolation, characterization, and engineering, but also in determining the optimal dose, timing, administration, and frequency of exosome therapy. Thus, optimization of exosome therapy is critical for the development of more effective and safer exosome-based therapies for acute skin wound healing and other diseases induced by cancer, ischemia, or inflammation. This review provides valuable insights into the potential of exosome therapy and highlights the need for further research to optimize exosome therapy for clinical use.

Keywords: exosomes; skin; stem cells; therapeutic impact; wound healing.

Fig. 1

Pathophysiological changes at different stages of skin wound healing. (A) At the hemostasis stage, platelets are activated and release various cytokines and growth factors, recruit immune cells and induce vasoconstriction. (B) In the stage of inflammatory response, macrophages and neutrophils gather at the site of injury, macrophages release inflammatory factors, and the M1 phenotype transitions to M2 phenotype to promote wound healing. (C) Endothelial cell vascularization and fibronectin migration promote collagen formation during the proliferation stage. (D) The main process during the remodeling stage involves the formation of type I and II collagen, as well as the reorganization of collagen and ECM. ECM, extracellular matrix.

Fig. 2

The mechanism of exosomes therapy for acute skin wound. (A) Exosomes of different cellular origins, such as fibroblast, macrophage, stem cell and platelet etc. (B) The role of exosomes in wound healing of the skin includes alleviating inflammatory reactions, promoting proliferation and migration of fibroblasts, promoting angiogenesis of endothelial cells, and accelerating remodeling of extracellular matrix and collagen. (C) Exosomes accelerate skin wound healing and reduce scar formation.

Fig. 3

Optimization of exosomes yield and therapy for skin acute wound healing, including optimization of exosome sources, culture conditions, storage conditions, isolation, genetic engineering and optimal does, timing, frequency, administration routine of exosomes.

Fig. 4

Engineered exosomes for skin wound healing, including surface and genetic engineering, precondition and loaded.