Diabetic wounds are among the most common complications of diabetes mellitus and their healing process can be delayed due to persistent inflammatory reactions, bacterial infections, damaged vascularization and impaired cell proliferation, which casts a blight on patients’health and quality of life. Therefore, new strategies to accelerate diabetic wound healing are being positively explored. Exosomes derived from mesenchymal stem cells (MSC-Exos) can inherit the therapeutic and reparative abilities of stem cells and play a crucial role in diabetic wound healing. However, poor targeting, low concentrations of therapeutic molecules, easy removal from wounds and limited yield of MSC-Exos are challenging for clinical applications. Bioengineering techniques have recently gained attention for their ability to enhance the efficacy and yield of MSC-Exos. In this review, we summarise the role of MSC-Exos in diabetic wound healing and focus on three bioengineering strategies, namely, parental MSC-Exos engineering, direct MSC-Exos engineering and MSC-Exos combined with biomaterials. Furthermore, the application of bioengineered MSC-Exos in diabetic wound healing is reviewed. Finally, we discuss the future prospects of bioengineered MSC-Exos, providing new insights into the exploration of therapeutic strategies.

中文翻译：

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生物工程间充质干细胞衍生的外泌体：糖尿病伤口愈合的新兴策略


糖尿病伤口是糖尿病最常见的并发症之一，由于持续的炎症反应、细菌感染、血管化受损和细胞增殖受损，伤口的愈合过程会被延迟，从而影响患者的健康和生活质量。因此，人们正在积极探索加速糖尿病伤口愈合的新策略。间充质干细胞衍生的外泌体（MSC-Exos）可以继承干细胞的治疗和修复能力，在糖尿病伤口愈合中发挥至关重要的作用。然而，MSC-Exos 的靶向性差、治疗分子浓度低、易于从伤口去除以及产量有限等问题对临床应用提出了挑战。生物工程技术最近因其提高 MSC-Exos 的功效和产量的能力而受到关注。在这篇综述中，我们总结了MSC-Exos在糖尿病伤口愈合中的作用，并重点讨论了三种生物工程策略，即亲代MSC-Exos工程、直接MSC-Exos工程以及MSC-Exos与生物材料相结合。此外，还回顾了生物工程MSC-Exos在糖尿病伤口愈合中的应用。最后，我们讨论了生物工程MSC-Exos的未来前景，为探索治疗策略提供了新的见解。