Division of Plastic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Int J Mol Sci. 2022 Mar 31;23(7):3869. doi: 10.3390/ijms23073869.
Soft tissue defects are common following trauma and tumor extirpation. These injuries can result in poor functional recovery and lead to a diminished quality of life. The healing of skin and muscle is a complex process that, at present, leads to incomplete recovery and scarring. Regenerative medicine may offer the opportunity to improve the healing process and functional outcomes. Barriers to regenerative strategies have included cost, regulatory hurdles, and the need for cell-based therapies. In recent years, exosomes, or extracellular vesicles, have gained tremendous attention in the field of soft tissue repair and regeneration. These nanosized extracellular particles (30-140 nm) can break the cellular boundaries, as well as facilitate intracellular signal delivery in various regenerative physiologic and pathologic processes. Existing studies have established the potential of exosomes in regenerating tendons, skeletal muscles, and peripheral nerves through different mechanisms, including promoting myogenesis, increasing tenocyte differentiation and enhancing neurite outgrowth, and the proliferation of Schwann cells. These exosomes can be stored for immediate use in the operating room, and can be produced cost efficiently. In this article, we critically review the current advances of exosomes in soft tissue (tendons, skeletal muscles, and peripheral nerves) healing. Additionally, new directions for clinical applications in the future will be discussed.
软组织缺损是创伤和肿瘤切除后常见的问题。这些损伤可导致功能恢复不良，生活质量下降。皮肤和肌肉的愈合是一个复杂的过程，目前导致不完全恢复和形成瘢痕。再生医学可能为改善愈合过程和功能结果提供机会。再生策略的障碍包括成本、监管障碍以及对细胞疗法的需求。近年来，外泌体或细胞外囊泡在软组织修复和再生领域引起了极大的关注。这些纳米级细胞外颗粒（30-140nm）可以打破细胞边界，并在各种再生生理和病理过程中促进细胞内信号传递。现有研究已经确定了外泌体通过不同机制再生肌腱、骨骼肌和周围神经的潜力，包括促进成肌生成、增加肌腱细胞分化和增强轴突生长以及施万细胞的增殖。这些外泌体可以储存起来，以便在手术室中立即使用，并且可以以低成本生产。本文对目前外泌体在软组织（肌腱、骨骼肌和周围神经）愈合中的应用进展进行了综述，并讨论了未来的临床应用新方向。
