[Some thoughts on the research of mesenchymal stem cell exosomes and wound microenvironment].

Since researchers have found that the conditioned medium and exosomes of mesenchymal stem cells (MSCs) had the biological effects equivalent to those of MSCs, MSC exosomes (MSC-Exos), the representative product of MSCs' paracrine effect, have become the research focus of the "cell-free" therapy of MSCs. However, most researchers currently use conventional culture condition to culture MSCs and then isolate exosomes for the treatment of wound or other diseases. Theoretically, the paracrine effect of MSCs is directly associated with the pathological condition of the wound (disease) microenvironment or in vitro culture condition, and their paracrine components and biological effects may be altered with the changes of the wound (disease) microenvironment or in vitro culture condition. Thus, the feasibility of using traditional culture condition to culture MSCs for exosome extraction for the treatment of different diseases without considering the actual situation of the disease to be treated needs further discussion. Therefore, the author suggests that the research of MSC-Exos should consider the microenvironment of the wound (disease) to be treated. as much as possible, otherwise the extracted MSC-Exos may not be "accurate" or may not really achieve the treatment effect of MSCs. In this article, we summarized some thoughts of the author and problems related to the researches about MSC-Exos and wound microenvironment, and hoped to discuss with researchers.自研究者们发现间充质干细胞条件培养基、外泌体具有与间充质干细胞等效的生物学效应时，间充质干细胞旁分泌效应的代表产物：间充质干细胞外泌体就成为间充质干细胞“无细胞”治疗的研究热点。但是，目前多数研究者采用传统培养条件培养间充质干细胞，分离外泌体用于治疗创面或者其他疾病。从理论上讲，间充质干细胞的旁分泌效应与创面（疾病）微环境的病理状况或者体外培养条件直接相关，其旁分泌的组分与生物学效应也会随着创面（疾病）微环境或体外培养条件的改变而发生改变。因此，不考虑拟治疗疾病的实际情况，仅仅采用传统培养条件培养间充质干细胞提取外泌体，治疗不同疾病的研究方案是否可行值得商榷。由此，笔者认为间充质干细胞外泌体的研究，应尽可能考虑拟治疗创面（疾病）微环境因素，否则提取的间充质干细胞外泌体可能不“精准”，或者说难以真正达到间充质干细胞的治疗效果。该文总结了笔者对目前间充质干细胞外泌体与创面微环境研究的相关思考与问题，希望与研究者共同商讨。.