Ku Ying C, Omer Sulaiman Hafsa, Anderson Spencer R, Abtahi Ali R
From the Department of Surgery, Campbell University School of Osteopathic Medicine, Buies Creek, NC.
Department of Surgery, Hull University Hospitals, Castle Hill Hospital, Cottingham, UK.
Plast Reconstr Surg Glob Open. 2023 Jun 12;11(6):e5051. doi: 10.1097/GOX.0000000000005051. eCollection 2023 Jun.
Despite an increasing surge of exosome use throughout the aesthetic arena, a paucity of published exosome-based literature exists. Exosomes are membrane-bound extracellular vesicles derived from various cell types, exerting effects via intercellular communication and regulation of several signaling pathways. The purpose of this review was to summarize published articles elucidating mechanisms and potential applications, report available products and clinical techniques, and prompt further investigation of this emerging treatment within the plastic surgery community.
A literature review was performed using PubMed with keywords exosomes, secretomes, extracellular vesicles, plastic surgery, skin rejuvenation, scar revision, hair growth, body contouring, and breast augmentation. Publications from 2010 to 2021 were analyzed for relevance and level of evidence. A Google search identified exosome distributors, where manufacturing/procurement details, price, efficacy, and clinical indications for use were obtained by direct contact and summarized in table format.
Exosomes are currently derived from bone marrow, placental, adipose, and umbilical cord tissue. Laboratory-based exosome studies demonstrate enhanced outcomes in skin rejuvenation, scar revision, hair restoration, and fat graft survival on the macro and micro levels. Clinical studies are limited to anecdotal results. Prices vary considerably from $60 to nearly $5000 based on company, source tissue, and exosome concentration. No exosome-based products are currently Food and Drug Administration-approved.
Administered alone or as an adjunct, current reports show promise in several areas of aesthetic plastic surgery. However, ongoing investigation is warranted to further delineate concentration, application, safety profile, and overall outcome efficacy.
尽管在整个美容领域使用外泌体的热潮日益高涨，但基于外泌体的已发表文献却很少。外泌体是源自各种细胞类型的膜结合细胞外囊泡，通过细胞间通讯和多种信号通路的调节发挥作用。本综述的目的是总结已发表的阐明机制和潜在应用的文章，报告可用产品和临床技术，并促使整形外科界对这种新兴治疗方法进行进一步研究。
使用PubMed进行文献综述，关键词为外泌体、分泌组、细胞外囊泡、整形外科、皮肤年轻化、瘢痕修复、头发生长、身体塑形和隆胸。分析了2010年至2021年的出版物的相关性和证据水平。通过谷歌搜索确定了外泌体经销商，通过直接联系获取了制造/采购细节、价格、功效和临床使用适应症，并以表格形式进行了总结。
外泌体目前来源于骨髓、胎盘、脂肪和脐带组织。基于实验室的外泌体研究表明，在宏观和微观层面上，外泌体在皮肤年轻化、瘢痕修复、毛发再生和脂肪移植存活方面都有更好的效果。临床研究仅限于轶事性结果。根据公司、来源组织和外泌体浓度的不同，价格差异很大，从60美元到近5000美元不等。目前没有基于外泌体的产品获得美国食品药品监督管理局的批准。
单独使用或作为辅助手段，目前的报告显示在外美容整形手术的几个领域都有前景。然而，需要进行持续的研究，以进一步明确浓度、应用、安全性和总体疗效。
