Engineered Extracellular Vesicles in Wound Healing: Design, Paradigms, and Clinical Application

Abstract

The severe quality of life and economic burden imposed by non‐healing skin wounds, infection risks, and treatment costs are affecting millions of patients worldwide. To mitigate these challenges, scientists are relentlessly seeking effective treatment measures. In recent years, extracellular vesicles (EVs) have emerged as a promising cell‐free therapy strategy, attracting extensive attention from researchers. EVs mediate intercellular communication, possessing excellent biocompatibility and stability. These features make EVs a potential tool for treating a plethora of diseases, including those related to wound repair. However, there is a growing focus on the engineering of EVs to overcome inherent limitations such as low production, relatively fixed content, and targeting capabilities of natural EVs. This engineering could improve both the effectiveness and specificity of EVs in wound repair treatments. In light of this, the present review will introduce the latest progress in the design methods and experimental paradigms of engineered EVs applied in wound repair. Furthermore, it will comprehensively analyze the current clinical research status and prospects of engineered EVs within this field.

Engineered Extracellular Vesicles in Chronic Kidney Diseases: A Comprehensive Review

“…Understanding the biogenesis and release of EVs is vital for unraveling their roles in health and disease. 21 Exosomes and microvesicles are involved in a multitude of processes, from contributing to normal cell functions to playing critical roles in various diseases. These vesicles are now recognized as an additional mode of cellular communication, allowing cells to exchange vital information in the form of their molecular cargo.…”

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

“…Maintaining cGMP compliance is paramount for guaranteeing the quality, safety, and consistency of MSC-EV therapies. Furthermore, it paves the way for regulatory approval and successful commercialization [ 143 , 144 ]. Several existing MSC-EV therapies serve as exemplary models for implementing these principles.…”

“…However, this model lacks congruence with clinical conditions, as the immunodeficient state may influence wound healing dynamics. Insufficient experimental evidence supports its advantages for MSC-EV research, particularly in the context of diabetic wound healing [ 143 ]. Alternative immunodeficient models, such as SCID (Severe Combined Immunodeficiency) mice or NOD/SCID (Non-Obese Diabetic/SCID) mice, could potentially offer advantages, but further research is needed to evaluate their suitability for MSC-EV-based wound healing studies.…”

Extracellular vesicles: Function, resilience, biomarker, bioengineering, and clinical implications

“…The clinical translation of engineered EVs holds immense promise for revolutionizing personalized medicine and therapeutic interventions. Engineered EVs offer targeted drug delivery, immunomodulatory effects, and regenerative potential for various diseases, including wound healing, cancer, neurodegenerative disorders, and inflammatory conditions [ 107 108 ]. However, the consistent isolation of EVs poses technical challenges, compounded by the intricate analyses necessary for their efficient study, which may hinder the utilization of pure EV populations as reliable biomarkers.…”