Exosomes From Adipose-Derived Stem Cells May Play Beneficial Role in Soft-Tissue Wound Healing

Wound or scar on arm.
Wound or scar on arm.
Recent advances in the field of ADSCs-Exos and their benefit in wound healing for skin regeneration are presented in this overview, which provides a perspective on how to best utilize this powerful cell-free therapy in the future.

Exosomes derived from adipose-derived stem cells (ADSCs-Exos) have a possible role in cutaneous wound healing, yet more research is needed to identify a strategy for utilizing ADSCs-Exos in the clinical environment, review data published in the Journal of Cosmetic Dermatology reports.

In the review, researchers from China provided an overview of ADSC-Exos — a promising alternative in the field of tissue regeneration — and their benefit in wound healing. The main potential effects of ADSCs depend primarily on paracrine-mediated mechanisms, it was noted. Inflammation, which represents the earliest response in wound repair, is an area in which ADSCs may be beneficial. In 1 study, intravenous injection of cell (MSC) Exos countered the JAK2-STAT6 signaling pathway-mediated macrophage activation in a dilated cardiomyopathy model, resulting in reductions in inflammatory factor expression levels.

Angiogenesis, a critical step in wound healing, is another area in which ADSCs may prove helpful. Exosomes from ADSCs have been associated with reductions in ulcerated areas or a diabetic foot ulcer rat model and an increase in the proliferation of endothelial progenitor cells and angiogenesis. These events were observed in a high glucose environment. In addition, adipose stem cell-derived extracellular vesicles have been shown to improve the in vivo angiogenic capacity of human microvascular endothelial cells.

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Other phases in which ADSC offer potential include wound proliferation and wound remodeling. A study showed that ADSC-Exos injection on full-thickness dorsal wounds in mice was associated with increases in collagen 3 to collagen 1 ratios, as well as TGF-β3 to TGF-β1 ratios. Infection with ADSC-Exos also prohibited the differentiation of fibroblasts into myofibroblasts. Exosomes also activated the ERK-MAPK pathway, ultimately promoting scarless cutaneous repair via regulation of ECM remodeling.

The studies included in this review were primarily performed in animal models with small population sizes, which limits the clinical applicability of the findings.

The formation and biologic mechanisms of exosomes that have an impact on wound healing “require further intense investigation to develop the approach into a clinical reality as an alternative to cell-based therapy,” the researchers wrote.

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Qiu H, Liu S, Wu K, et al. Prospective application of exosomes derived from adipose-derived stem cells in skin wound healing: A review [published online November 21, 2019]. J Cosmet Dermatol. doi:10.1111/jocd.13215