Ash Makenna, Zibitt Meira, Shauly Orr, Menon Ambika, Losken Albert, Gould Daniel
Aesthet Surg J Open Forum. 2024 Mar 19;6:ojae017. doi: 10.1093/asjof/ojae017. eCollection 2024.
Topical antiaging therapies provide noninvasive delivery of active therapeutics. Exosomes, or extracellular nanovesicles, and peptides, small strings of amino acids, have shown promise as topical therapies in early trials, but neither is FDA approved. This review aims to elucidate the current and future landscape of topical exosomes and peptides as therapeutics for skin rejuvenation. A literature search was conducted using the keywords "peptides" OR "exosomes" AND "skin" OR "rejuvenation." Primary endpoints included mechanisms of action in humans or live animals as well as clinical data supporting the use of exosomes or peptides topically for skin rejuvenation or wound healing. Secondary endpoints were safety, side effects, and efficacy. The articles were collected, organized, and sorted using the Covidence software (Melbourne, Australia) for systematic review. Nine articles evaluating topical application of exosomes and 9 of peptides met inclusion criteria. Topical exosomes were found to increase collagen deposition, accelerate wound healing, and improve overall cosmesis. Several clinical trials are currently underway. Topical peptides were found to improve appearance of fine lines and wrinkles, elasticity and viscoelasticity, skin texture, skin thickness, and the potential for accelerated wound healing. Peptides are quite common in "cosmeceutical" products, and several patents have been filed for topical peptide products aimed at increasing skin rejuvenation. This could indicate a movement toward pursuing FDA approval. The future of topical exosome and peptide products for the purpose of skin rejuvenation appears promising. Preliminary data from the studies reviewed here indicates that these products have the potential to be safe and effective.
局部抗老化疗法可实现活性治疗药物的非侵入性递送。外泌体，即细胞外纳米囊泡，以及肽（氨基酸短链）在早期试验中已显示出作为局部疗法的潜力，但均未获得美国食品药品监督管理局（FDA）的批准。本综述旨在阐明局部应用外泌体和肽作为皮肤年轻化治疗方法的现状和未来前景。使用关键词“肽”或“外泌体”以及“皮肤”或“年轻化”进行了文献检索。主要终点包括在人类或活体动物中的作用机制以及支持局部使用外泌体或肽进行皮肤年轻化或伤口愈合的临床数据。次要终点为安全性、副作用和疗效。使用Covidence软件（澳大利亚墨尔本）收集、整理和分类这些文章以进行系统综述。九篇评估外泌体局部应用的文章和九篇评估肽的文章符合纳入标准。发现局部应用外泌体可增加胶原蛋白沉积、加速伤口愈合并改善整体美容效果。目前正在进行多项临床试验。发现局部应用肽可改善细纹和皱纹外观、弹性和粘弹性、皮肤质地、皮肤厚度以及加速伤口愈合的潜力。肽在“药妆品”中相当常见，并且已经为旨在促进皮肤年轻化的局部肽产品提交了多项专利。这可能表明朝着寻求FDA批准的方向发展。用于皮肤年轻化目的的局部外泌体和肽产品的未来前景似乎很广阔。此处综述的研究的初步数据表明，这些产品有可能是安全有效的。
