Liu Chuanqi, Cheng Chen, Cheng Kun, Gao Allen S, Li Qingfeng, Atala Anthony, Zhang Yuanyuan
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, 64108-2718, USA.
J Transl Med. 2025 May 23;23(1):578. doi: 10.1186/s12967-025-06578-0.
The dysfunction of wound-healing processes can result in chronic non-healing wounds and pathological scar formation. Current treatment options often fall short, necessitating innovative approaches. Exosomes, extracellular vesicles secreted by various cells, have emerged as promising therapeutic agents serving as an intercellular communication system. By engineering exosomes, their cargo and surface properties can be tailored to enhance therapeutic efficacy and specificity. Engineered exosomes (eExo) are emerging as a favorable tool for treating non-healing wounds and pathological scars. In this review, we delve into the underlying mechanisms of non-healing wounds and pathological scars, outline the current state of engineering strategies, and explore the clinical potential of eExo based on preclinical and clinical studies. In addition, we address the current challenges and future research directions, including standardization, safety and efficacy assessments, and potential immune responses. In conclusion, eExo hold great promise as a novel therapeutic approach for non-healing wounds and non-healing wounds and pathological scars. Further research and clinical trials are warranted to translate preclinical findings into effective clinical treatments.
伤口愈合过程的功能障碍可导致慢性难愈合伤口和病理性瘢痕形成。目前的治疗选择往往效果不佳，因此需要创新方法。外泌体是各种细胞分泌的细胞外囊泡，已成为有前景的治疗剂，可作为细胞间通讯系统。通过对外泌体进行工程改造，可以调整其内容物和表面特性，以提高治疗效果和特异性。工程化外泌体（eExo）正在成为治疗难愈合伤口和病理性瘢痕的有利工具。在这篇综述中，我们深入探讨难愈合伤口和病理性瘢痕的潜在机制，概述工程策略的现状，并基于临床前和临床研究探索eExo的临床潜力。此外，我们还讨论了当前的挑战和未来的研究方向，包括标准化、安全性和疗效评估以及潜在的免疫反应。总之，eExo作为一种治疗难愈合伤口和病理性瘢痕的新型治疗方法具有很大的潜力。需要进一步的研究和临床试验，将临床前研究结果转化为有效的临床治疗方法。
