Stem cell‐derived exosomes in the treatment of melasma and its percutaneous penetration

Abstract

Background and Objectives: Melasma is a refractory skin disease due to its complex pathogenesis and difficult treatment. Studies have found that human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-Exos) could serve as a novel cell-free therapeutic strategy in regenerative and esthetic medicine. It could potentially treat melasma, but the skin barrier is a challenge. In this study, we aim to explore the safety and efficacy of hUCMSC-Exos in the treatment of melasma and the means to promote its percutaneous penetration. Materials and Methods: In the animal study about the effect of penetration, percutaneous penetration of PKH67-labeled hUCMSC-Exos was studied under microneedles, 1565 nm nonablative fractional laser (NAFL), and a plasma named Peninsula Blue Aurora Shumin Master (PBASM) treatments, observed by confocal laser scanning microscopy. In the clinical application study, 60 patients with melasma treated in our department were divided into four groups. NAFL combined with normal saline treatment was used for Group A. Microneedles, NAFL, and PBASM combined with hUCMSC-Exos treatments were used for Groups B, C, and D, respectively. Each patient received four treatments at 1-month intervals. Assessments were done using the degree of pain posttreatment, melasma area and severity score, improvement rate, physician global assessment score, satisfaction, and complications. Results: In the animal study about the effect of penetration, hUCMSC-Exos can penetrate the deep dermis under microneedles, NAFL, and PBASM treatments. In the clinical application study, compared with Group A, Groups B, C, and D showed significantly improved therapeutic effect and patient satisfaction (p < 0.05), and there was no significant difference among Groups B, C, and D.(p > 0.05). Patients in Group B reported higher pain levels than those in the other three groups (p < 0.05); the treatment experience of patients in Group D was better. Conclusion: hUCMSC-Exos can improve the symptoms of melasma safely and effectively. Compared with microneedles, NAFL and PBASM can also achieve a good effect toward promoting penetration. These findings are worthy of exploration and clinical application.

Umbilical cord‐derived mesenchymal stem cell secretome promotes skin regeneration and rejuvenation: From mechanism to therapeutics

“…58,75,76 When directly dissolved, it can be infiltrated percutaneously or injected intradermally, such as using microneedles. 122,123 Common materials used for biological or artificial scaffolds are hydrogels, chitosan, hyaluronic acid (HA), and so forth. Application combined with scaffolds has more benefits than using them directly.…”

“…Scaffolds, like the secretome‐containing gel, are typically applied or injected into the wound, followed by protective fixation for the wound with a wound dressing or patch to maintain a moist and sterile environment 58,75,76 . When directly dissolved, it can be infiltrated percutaneously or injected intradermally, such as using microneedles 122,123 …”

“…Another study showed effective alleviation of melasma in patients after 4 treatments each 1 month apart. They also compared the results of the secretome treatment combined with microneedling, fractional laser, and radiofrequency, with the highest patient satisfaction of 86.7% combined with radiofrequency 122 . None of the aforementioned studies reveal any adverse effects brought on by the secretome.…”

“… 58 , 75 , 76 When directly dissolved, it can be infiltrated percutaneously or injected intradermally, such as using microneedles. 122 , 123 …”

“… 131 In addition to combining microneedles, UCMSC‐exo can be combined with fractional laser and radiofrequency, and they have significantly improved the treatment of melasma (Table 1 ). 122 …”