Mesenchymal Stem Cell-Derived Exosomes: Mechanisms and Applications in Chronic Wound Repair

Wound healing remains a significant clinical challenge, often associated with prolonged recovery times, high healthcare costs, and substantial emotional and physical burdens for patients. Despite advancements in treatment modalities, there is a pressing need for innovative and effective therapeutic strategies. Mesenchymal stem cell (MSC) therapy has emerged as a promising approach due to its regenerative potential; however, its clinical application is hindered by concerns such as complex handling requirements and risks of undesired differentiation. Recent research has highlighted that the therapeutic benefits of MSCs are primarily mediated through paracrine signaling, particularly via exosomes. Exosomes are a subclass of extracellular vesicles rich in bioactive molecules, including proteins, lipids, DNA and various forms of RNA, and serve as critical mediators of intercellular communication. This review aims to comprehensively examine the role of MSC-derived exosomes in wound healing, emphasizing their mechanisms of action, advantages over stem cell-based therapies, and current progress in preclinical and clinical applications. By synthesizing the latest research, we underscore the transformative potential of exosome-based therapies as a next-generation solution for efficient and targeted wound management.