Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, 430060, China.
J Nanobiotechnology. 2024 Jul 5;22(1):398. doi: 10.1186/s12951-024-02684-1.
Diabetic wounds are characterized by incomplete healing and delayed healing, resulting in a considerable global health care burden. Exosomes are lipid bilayer structures secreted by nearly all cells and express characteristic conserved proteins and parent cell-associated proteins. Exosomes harbor a diverse range of biologically active macromolecules and small molecules that can act as messengers between different cells, triggering functional changes in recipient cells and thus endowing the ability to cure various diseases, including diabetic wounds. Exosomes accelerate diabetic wound healing by regulating cellular function, inhibiting oxidative stress damage, suppressing the inflammatory response, promoting vascular regeneration, accelerating epithelial regeneration, facilitating collagen remodeling, and reducing scarring. Exosomes from different tissues or cells potentially possess functions of varying levels and can promote wound healing. For example, mesenchymal stem cell-derived exosomes (MSC-exos) have favorable potential in the field of healing due to their superior stability, permeability, biocompatibility, and immunomodulatory properties. Exosomes, which are derived from skin cellular components, can modulate inflammation and promote the regeneration of key skin cells, which in turn promotes skin healing. Therefore, this review mainly emphasizes the roles and mechanisms of exosomes from different sources, represented by MSCs and skin sources, in improving diabetic wound healing. A deeper understanding of therapeutic exosomes will yield promising candidates and perspectives for diabetic wound healing management.
糖尿病伤口的特点是愈合不完全和愈合延迟，这导致了相当大的全球医疗保健负担。外泌体是几乎所有细胞分泌的脂质双层结构，表达特征性保守蛋白和亲代细胞相关蛋白。外泌体中蕴藏着多种具有生物活性的大分子和小分子，它们可以作为不同细胞之间的信使，触发受体细胞的功能变化，从而赋予治疗各种疾病的能力，包括糖尿病伤口。外泌体通过调节细胞功能、抑制氧化应激损伤、抑制炎症反应、促进血管再生、加速上皮再生、促进胶原重塑和减少瘢痕形成来加速糖尿病伤口愈合。来自不同组织或细胞的外泌体可能具有不同水平的功能，并能促进伤口愈合。例如，间充质干细胞衍生的外泌体（MSC-exos）由于其优异的稳定性、通透性、生物相容性和免疫调节特性，在愈合领域具有良好的潜力。源自皮肤细胞成分的外泌体可以调节炎症，促进关键皮肤细胞的再生，从而促进皮肤愈合。因此，本综述主要强调了以间充质干细胞和皮肤来源为代表的不同来源的外泌体在改善糖尿病伤口愈合中的作用和机制。对外泌体治疗的深入了解将为糖尿病伤口愈合管理提供有前景的候选物和视角。
