Wound Healing: Harnessing Extracellular Vesicles Derived from Adipose-Derived Stem Cells
Summary: This review explores adipose-derived stem cells (ADSCs) and their extracellular vesicles (ADSC-EVs) as promising therapies for chronic wounds, including DFUs. ADSC transplantation accelerates healing across wound types while reducing scarring; ADSC-EVs, as key paracrine mediators, offer advantages like stability and no immunogenicity. ADSC-EVs modulate the wound microenvironment by promoting keratinocyte migration (via AKT/HIF-1α), M2 macrophage polarization (via miR-124-5p), angiogenesis (via SIRT3/SOD2), and ECM remodeling (via miR-192-5p). Preconditioning (hypoxia/ultrasound) and biomaterials (hydrogels) enhance delivery; clinical trials show improved closure and regeneration, though larger DFU studies needed.
Key Highlights:
- ADSC-EVs Cargo: Proteins (growth factors), ncRNAs (miRNAs like miR-21-5p for fibrosis inhibition).
- Mechanisms: Re-epithelialization via Wnt/β-catenin; anti-inflammation via H19/miR-130b-3p; angiogenesis via EGR-1/VEGF.
- Preconditioning: Hypoxia increases EV yield 2x; ultrasound improves targeting.
- Delivery: Hydrogels/scaffolds for sustained release; microneedles for transdermal.
- Clinical: Trials show 30-50% faster closure in DFUs; safe, minimal scarring.
Keywords: ADSC-EVs, wound healing, DFU, paracrine, preconditioning, Qisong Liu, Cuiping Zhang, Yujie Liang