Nahm William J, Nikas Christos, Goldust Mohamad, Horneck Nadine, Cervantes Juan Antonio, Burshtein Joshua, Tsoukas Maria
New York University Grossman School of Medicine, New York, New York, USA.
Columbia University, New York, New York, USA.
Int J Dermatol. 2025 Jun 18. doi: 10.1111/ijd.17903.
Recent advances have highlighted exosomes as promising therapeutic, prognostic, and diagnostic agents in dermatology and aesthetic medicine, suggesting their expanding role in various skin conditions. This comprehensive review examines the current applications and future directions of exosomes in dermatological practice. The analysis of available literature reveals a growing market of exosome-based products internationally and within the United States, with diverse formulations primarily derived from human stem cells. Clinical studies of exosomes have demonstrated clinical efficacy in addressing skin aging, scarring, hair restoration, and melasma. Additionally, exosomes show potential as therapeutic agents for inflammatory skin conditions like atopic dermatitis and as prognostic and diagnostic biomarkers for various dermatological disorders including psoriasis, vitiligo, and melanoma. Despite promising results, challenges remain in the standardization of isolation protocols, optimization of delivery systems, and establishment of regulatory frameworks. Proper characterization of exosome cargo is necessary to ensure safety and efficacy. Future applications may include engineered exosomes with enhanced targeting capabilities, plant-derived formulations with improved penetration, and combination therapies integrating exosomes with established dermatological procedures for improved outcomes across cosmetic, wound healing, and oncological applications. Exosome-based therapies may represent a paradigm shift in dermatological treatment, yet their transition from promising research to mainstream clinical practice hinges on overcoming key technical and regulatory obstacles.
最近的进展突出了外泌体在皮肤病学和美容医学中作为有前景的治疗、预后和诊断试剂的地位，表明它们在各种皮肤疾病中的作用不断扩大。这篇综述探讨了外泌体在皮肤科实践中的当前应用和未来方向。对现有文献的分析表明，在国际上和美国，基于外泌体的产品市场不断增长，其配方多样，主要来源于人类干细胞。外泌体的临床研究已证明其在解决皮肤老化、瘢痕形成、毛发再生和黄褐斑方面具有临床疗效。此外，外泌体显示出作为特应性皮炎等炎症性皮肤病治疗剂的潜力，以及作为银屑病、白癜风和黑色素瘤等各种皮肤病的预后和诊断生物标志物的潜力。尽管取得了令人鼓舞的结果，但在分离方案的标准化、递送系统的优化以及监管框架的建立方面仍存在挑战。对外泌体货物进行适当表征对于确保安全性和有效性至关重要。未来的应用可能包括具有增强靶向能力的工程化外泌体、具有改善渗透性的植物源配方，以及将外泌体与既定皮肤科程序相结合的联合疗法，以在美容、伤口愈合和肿瘤学应用中取得更好的效果。基于外泌体的疗法可能代表皮肤病治疗的范式转变，但其从有前景的研究向主流临床实践的转变取决于克服关键的技术和监管障碍。
