Authors
Danna Yao, Yujie Xiao, Mali Zhou, Panpan Sun, Ling Wang, Hongtao Wang
Published in
Stem cells international. Volume 2026. Pages 4151678. Epub Sep 18, 2026.
Abstract
Diabetic wounds are sustained by persistent inflammation, impaired angiogenesis, abnormal extracellular matrix (ECM) remodeling, and delayed re-epithelialization. Adipose-derived stem cell exosomes (ADSC-Exos) offer a cell-free strategy because their multicomponent cargo can modulate immune responses, vascular regeneration, fibroblast activity, and epidermal repair. Mechanistic studies suggest that ADSC-Exos promote macrophage immunometabolic reprogramming, restore pro-angiogenic signaling, improve matrix homeostasis, and protect keratinocytes from oxidative injury. Engineering approaches and biomaterial-based delivery systems may further improve local retention, controlled release, and therapeutic activity. Distinct from existing ADSC-Exos reviews, this review adopts a pathology-to-translation framework that connects the major pathological features of diabetic wounds with ADSC-Exos mechanisms, engineering strategies, delivery optimization, and clinical translation. Particular emphasis is placed on donor- and process-dependent heterogeneity, potency assessment, GMP-compatible manufacturing, biodistribution, long-term safety, and regulation. Overall, ADSC-Exos represent a mechanistically compelling preclinical platform, but clinical translation will require reproducible product quality, standardized potency criteria, scalable manufacturing, and rigorous clinical validation.
PMID:
42761902
Bibliographic data and abstract were imported from PubMed on 26 Oct 2026.
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