The use of therapeutic exosomes for in vivo wound healing

Normal wound healing is a complex, yet critical process. Unfortunately, delayed or impaired wound healing presents a significant burden for numerous patients worldwide. Recent research has demonstrated that exosomes, a subtype of extracellular vesicles, may play a pivotal role in mediating cell-cell communication during wound healing. This narrative review aims to explore the use of exosomes in wound healing, with a focus on in vivo application of exosomes in animal wound models. A total of 73 studies are outlined in this narrative review, exploring either excisional, diabetic, burn, ischemic, or pressure wounds. Overall, the most frequent source of exosomes was adipose-derived mesenchymal stem cells, and the most common application method was local or subcutaneous injection. While these studies demonstrated great promise for the use of exosomes for therapeutic use in wound healing, this review also discusses the challenges and obstacles that will need to be overcome, including standardizing methods, further characterizing exosomes and identifying the optimal sources and doses in the development of exosome therapies.