Chronic wounds are wounds that cannot heal properly due to various factors, such as underlying diseases, infection or reinjury, and improper healing of skin wounds and ulcers can cause a serious economic burden. Numerous studies have shown that extracellular vesicles (EVs) derived from stem/progenitor cells promote wound healing, reduce scar formation and have significant advantages over traditional treatment methods. EVs are membranous particles that carry various bioactive molecules from their cellular origins, such as cytokines, nucleic acids, enzymes, lipids and proteins. EVs can mediate cell-to-cell communication and modulate various physiological processes, such as cell differentiation, angiogenesis, immune response and tissue remodelling. In this review, we summarize the recent advances in EV-based wound healing, focusing on the signalling pathways that are regulated by EVs and their cargos. We discuss how EVs derived from different types of stem/progenitor cells can promote wound healing and reduce scar formation by modulating the Wnt/β-catenin, phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin, vascular endothelial growth factor, transforming growth factor β and JAK–STAT pathways. Moreover, we also highlight the challenges and opportunities for engineering or modifying EVs to enhance their efficacy and specificity for wound healing.

中文翻译：

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细胞外囊泡调节难治性伤口愈合的关键信号通路

慢性伤口是指由于基础疾病、感染或再损伤等多种因素而无法正常愈合的伤口，皮肤伤口和溃疡愈合不当会造成严重的经济负担。大量研究表明，源自干/祖细胞的细胞外囊泡（EV）可促进伤口愈合，减少疤痕形成，与传统治疗方法相比具有显着优势。EV 是膜颗粒，携带细胞来源的各种生物活性分子，如细胞因子、核酸、酶、脂质和蛋白质。EVs可以介导细胞间的通讯并调节各种生理过程，例如细胞分化、血管生成、免疫反应和组织重塑。在这篇综述中，我们总结了基于 EV 的伤口愈合的最新进展，重点关注由 EV 及其货物调节的信号通路。我们讨论了来自不同类型干细胞/祖细胞的 EV 如何通过调节 Wnt/β-连环蛋白、磷酸肌醇 3-激酶/蛋白激酶 B/哺乳动物雷帕霉素靶点、血管内皮生长因子、转化来促进伤口愈合并减少疤痕形成。生长因子 β 和 JAK-STAT 途径。此外，我们还强调了设计或修改电动汽车以提高其伤口愈合功效和特异性的挑战和机遇。