Mesenchymal Stem Cell-derived Exosomes in the Treatment of Skin andSubcutaneous Tissue Diseases: A Review

Skin and subcutaneous tissue diseases (SSTDs) are a leading cause of nonfatal disability worldwide, particularly in resource-poor regions, affecting over one-third of the world's population. Current treatments for SSTDs include topical and oral medications, as well as mechanotherapy; however, these approaches have several significant limitations, including insufficient efficacy, side effects, and high costs. In this regard, particular interest is directed to mesenchymal stem cell-derived exosomes (MSC-Exo), the therapeutic properties of which have been actively studied worldwide in recent years. Our aim was to review clinical trials, published clinical studies, and case reports on MSC-Exo-based cell-free therapy for SSTDs, summarizing both its opportunities and challenges for clinical translation. A literature search for clinical studies and case reports of the application of MSCExo in the treatment of SSTDs was conducted using PubMed, Google Scholar databases, and ClinicalTrials. gov. The analysis revealed that MSC-Exo are utilized in treating diverse SSTDs, including: alopecia and hair thinning, psoriasis, facial redness in patients with atopic dermatitis, sensitive skin, melasma, skin wounds, ulcers and burns, skin aging, hyperpigmentation, scars, and dystrophic epidermolysis bullosa. Ongoing clinical trials and preliminary published clinical studies and case reports demonstrate that MSC-Exo are safe and effective cell-free therapeutic agents, highlighting their potential as a novel treatment for SSTDs.