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Review
. 2025 Jul 5;26(13):6481.
doi: 10.3390/ijms26136481.

A Paradigm Shift in SSTI Management: The Multifunctional Role of Extracellular Vesicles

Barathan Muttiah  1 , Alfizah Hanafiah  1   2
Affiliations
Review

A Paradigm Shift in SSTI Management: The Multifunctional Role of Extracellular Vesicles

Barathan Muttiah et al. Int J Mol Sci. .

Abstract

Skin and soft tissue infections (SSTIs) are becoming an urgent public health issue worldwide. The globe is facing a growing problem with drug-resistant germs, and current treatments are not quite cutting it. There is a real need for new therapies that can tackle these challenges more effectively. This brings us to an interesting question: Can extracellular vesicles (EVs) from different sources, such as mesenchymal stem cells (MSCs), immune cells, or even plants and animals, help in treating SSTIs, especially given the rise in drug resistance? Studies have shown that MSC-derived EVs are particularly noteworthy because they carry components such as antimicrobial peptides (AMPs) that can work together to fight infections, boost the immune response, and aid in healing. These vesicles play a role in how our body interacts with infections, helping to clear bacteria, reduce inflammation, and promote tissue repair. We also see that EVs from plants and bacteria can directly fight off germs, while those from animals can support the healing process of skin. Although early studies have shown promise for EV therapies, there are still hurdles to overcome, such as ensuring consistent production and delivery. This review looks at the potential of EVs as powerful agents in managing infections and supporting healing, highlighting an exciting area of research in medicine.

Keywords: antimicrobial resistance; extracellular vesicles (EVs); mesenchymal stem cells (MSCs); skin and soft tissue infections (SSTIs); wound healing.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Figure 1
Figure 1
Overview of the epidemiological burden, risk factors, and emerging therapies for SSTIs.
Figure 2
Figure 2
The biogenesis and release of EVs. Abbreviations: EVs (Extracellular Vesicles); ILVs (Intraluminal Vesicles); ESCRT (Endosomal Sorting Complex Required for Transport); VPS4 (Vacuolar Protein Sorting-Associated Protein 4); CD9/CD63/CD81 (Tetraspanins—common EV surface markers); TEMs (Tetraspanin-Enriched Microdomains); Rab GTPases (Ras-related GTP-binding proteins involved in vesicle trafficking); Rab27/Rab11/Rab35 (Rab family GTPases regulating EV secretion); SNARE (Soluble NSF Attachment Protein Receptor); ARF6 (ADP-Ribosylation Factor 6); Rho GTPases (Ras Homolog GTPases involved in cytoskeletal dynamics); Annexin A1 (Phospholipid-binding protein involved in EV biogenesis and trafficking).
Figure 3
Figure 3
Comparison of EVs from Gram-negative and Gram-positive bacteria.
See this image and copyright information in PMC

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