Wound Healing: Harnessing Extracellular Vesicles Derived from Adipose-Derived Stem Cells

Chronic wounds present a significant clinical challenge, placing a heavy burden on patients and highlighting the need for more effective treatments. Among emerging strategies, adipose-derived stem cells (ADSCs) and their extracellular vesicles (ADSC-EVs) show great promise due to their potent wound-healing capabilities. Clinical evidence indicates that ADSC transplantation effectively promotes healing across diverse chronic wound types, improving healing quality while reducing pathological scarring. As key paracrine mediators of ADSCs, ADSC-EVs have garnered considerable interest for their advantages in therapeutic development and reparative functions. ADSC-EVs precisely modulate critical cells within the wound microenvironment, including keratinocytes, macrophages, endothelial cells, and fibroblasts. This modulation promotes re-epithelialization, resolves inflammation, stimulates angiogenesis, and modulates extracellular matrix remodeling. These regulatory effects are attributed to the rich cargo of bioactive molecules carried by ADSC-EVs, including proteins and non-coding RNAs. Notably, preconditioning strategies and functional delivery materials can further enhance the modulatory effects of ADSC-EVs by enriching them with specific therapeutic molecules and enabling controlled release. Furthermore, ADSC-EVs serve as efficient drug delivery vehicles for exogenous therapeutics, enabling synergistic effects. In summary, both ADSCs and ADSC-EVs demonstrate considerable clinical potential for chronic wound management.