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Exosomes, ranging from 40 to 160 nm in diameter, are extracellular lipid bilayer microvesicles that regulate the body’s physiological and pathological processes and are secreted by cells that contain proteins, nucleic acids, amino acids and other metabolites. Previous studies suggested that mesenchymal stem cell (MSC)-derived exosomes could either...
Citations
... ADSC-CM is a wide-spectrum bioactive factor released by ADSC into the culture medium during cell culture and has been shown to promote wound healing and immunomodulation [53,54]. ADSC-CM can reduce the cost of treatment and avoid the safety issues associated with stem cell therapy, but the short lifespan of the active ingredient, which is rapidly diluted and eliminated by diffusion, limits its use [55][56][57]. It has been reported that under hypoxic conditions, ADSCs may activate hypoxia inducible factor 1α (HIF-1α), thereby stimulating the proliferation of ADSCs and promoting the secretion of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF) and basic fibroblast growth factor (bFGF) [58,59]. ...
... ADSC-Exo is enriched with proteins, lipids, and nucleic acids, which are involved in cell proliferation, apoptosis, immunomodulation, and remodeling of the ECM [61]. In addition, they are not rejected by the immune system and have a homing dose that is easy to control [55]. In contrast to ADSCs, ADSC-Exo is a novel cell-free therapeutic technique that circumvents the challenges and dangers associated with the use of natural or synthetic stem cells [60]. ...
Scar tissue is the inevitable result of repairing human skin after it has been subjected to external destructive stimuli. It leads to localized damage to the appearance of the skin, accompanied by symptoms such as itching and pain, which reduces the quality of life of the patient and causes serious medical burdens. With the continuous development of economy and society, there is an increasing demand for beauty. People are looking forward to a safer and more effective method to eliminate pathological scarring. In recent years, adipose-derived stem cells (ADSCs) have received increasing attention from researchers. It can effectively improve pathological scarring by mediating inflammation, regulating fibroblast proliferation and activation, and vascular reconstruction. This review focuses on the pathophysiological mechanisms of hypertrophic scarring, summarizing the therapeutic effects of in vitro, in vivo, and clinical studies on the therapeutic effects of ADSCs in the field of hypertrophic scarring prevention and treatment, the latest application techniques, such as cell-free therapies utilizing ADSCs, and discussing the advantages and limitations of ADSCs. Through this review, we hope to further understand the characterization of ADSC and clarify the effectiveness of its application in hypertrophic scarring treatment, so as to provide clinical guidance.
Supplementary Information
The online version contains supplementary material available at 10.1186/s13287-024-03749-6.
... 99 In addition to stem cells and conditioned medium, exosomes perform therapeutic roles in hypertrophic scars and keloids. [119][120][121] Thus, the role of exosome-based hydrogels in pathologic scars is worth exploring in the future. ...
... 122 Nanomaterials applied in hypertrophic scars and keloids mainly include nanoparticles, liposomes, carbon nanomaterials, and metallic nanoparticles. Liposomes and exosomes were described above; 106,121 thus, in this section, we mainly discuss metal ions and carbon nanomaterials in pathologic scars. Silver ions are widely used in skin dressings and facilitate wound healing, given their antimicrobial effects. ...
Hypertrophic scars and keloids are common fibroproliferative diseases following injury. Patients with pathologic scars suffer from impaired quality of life and psychological health due to appearance disfiguration, itch, pain, and movement disorders. Recently, the advancement of hydrogels in biomedical fields has brought a variety of novel materials, methods and therapeutic targets for treating hypertrophic scars and keloids, which exhibit broad prospects. This review has summarized current research on hydrogels and loaded components used in preventing and treating hypertrophic scars and keloids. These hydrogels attenuate keloid and hypertrophic scar formation and progression by loading organic chemicals, drugs, or bioactive molecules (such as growth factors, genes, proteins/peptides, and stem cells/exosomes). Among them, smart hydrogels (a very promising method for loading many types of bioactive components) are currently favoured by researchers. In addition, combining hydrogels and current therapy (such as laser or radiation therapy, etc.) could improve the treatment of hypertrophic scars and keloids. Then, the difficulties and limitations of the current research and possible suggestions for improvement are listed. Moreover, we also propose novel strategies for facilitating the construction of target multifunctional hydrogels in the future.
