Advancements in engineered exosomes for wound repair: current research and future perspectives

Abstract

Wound healing is a complex and prolonged process that remains a significant challenge in clinical practice. Exosomes, a type of nanoscale extracellular vesicles naturally secreted by cells, are endowed with numerous advantageous attributes, including superior biocompatibility, minimal toxicity, and non-specific immunogenicity. These properties render them an exceptionally promising candidate for bioengineering applications. Recent advances have illustrated the potential of exosome therapy in promoting tissue repair. To further augment their therapeutic efficacy, the concept of engineered exosomes has been proposed. These are designed and functionally modifiable exosomes that have been tailored on the attributes of natural exosomes. This comprehensive review delineates various strategies for exosome engineering, placing specific emphasis on studies exploring the application of engineered exosomes for precision therapy in wound healing. Furthermore, this review sheds light on strategies for integrating exosomes with biomaterials to enhance delivery effectiveness. The insights presented herein provide novel perspectives and lay a robust foundation for forthcoming research in the realm of cutaneous wound repair therapies.

Engineered nanovesicles from activated neutrophils with enriched bactericidal proteins have molecular debridement ability and promote infectious wound healing

“…Our studies have substantiated the bactericidal ability of engineered NVs to precisely and effectively promote infectious wound healing, offering a promising avenue for clinical wound repair. Nonetheless, challenges persist in terms of the quality, purity and yield of the prepared NVs, as well as the storage conditions of loaded engineered NVs [ 36 ]; the possible side effects of systemic use of vesicles as therapeutic agents should also be considered, all of which require further refinement [ 37 ].…”

Optimizing mesenchymal stem cell extracellular vesicles for chronic wound healing: Bioengineering, standardization, and safety

“…cGMP standards, enforced by regulatory agencies like the U.S. Food and Drug Administration (FDA), ensure the quality, safety, and consistency of pharmaceutical products, including biologics like MSC-EVs [ 48 , 52 ]. These regulations punctiliously govern every facet of the manufacturing process, from initial raw material acquisition to final product release [ 142 ]. Achieving cGMP compliance for MSC-EV production necessitates careful design, installation, and consistent maintenance of manufacturing facilities and equipment, coupled with rigorous testing and qualification of raw materials.…”

“…To gain a clear understanding of how these EVs impact chronic wound healing, it is crucial to accurately identify their subclasses using advanced techniques such as high-resolution flow cytometry, which analyzes particle characteristics at a microscopic level, and multiomics computational analysis, integrating various types of biological data such as genomics, proteomics, and transcriptomics [ 48 , 52 ]. Collaborative efforts with wound care specialists are key to developing scalable and potent assays that enable precise predictions of the diverse bioactivities underlying the clinical potential of MSC-EV treatments [ 142 , 148 ].…”

Clinical Efficacy of Extracellular Vesicle Therapy in Periodontitis: Reduced Inflammation and Enhanced Regeneration

“…They transport many biomolecules, including proteins, lipids, and nucleic acids, between cells, modulating various physiological and pathological processes [ 10 ]. Exosomes can carry and deliver interleukins [ILs] to target cells, thus modulating immune responses and facilitating tissue repair and regeneration [ 11 ]. Although periodontitis is not typically categorized as an “immunomodulatory disease” per se, its progression and pathology are deeply intertwined with immunomodulatory processes [ 12 ].…”

“…However, they can also serve as potential therapeutic targets for controlling the disease’s progression [ 13 , 14 ]. Additionally, the response of cells to ILs can lead to the release of exosomes, which further influences the regenerative process [ 11 ]. This synergistic relationship is a key area of research in regenerative medicine, as understanding and harnessing these interactions could lead to novel therapeutic strategies that circumvent the limitations of conventional treatment modalities for a wide range of diseases and injuries, including periodontitis [ 15 ].…”