Background Wound healing has always been a serious issue for doctors and primary health care systems. In addition, adipose stem cell-derived exosomes have been proven to play a positive and effective role in tissue repair and regeneration. A systematic review of these preclinical studies was performed to assess the efficacy of adipose stem cell-derived exosomes (ADSC-Exos) in treating wounds. This article aimed to study the effectiveness of ADSC-Exos for the treatment of animal skin wounds and includes a meta-analysis of exosomes from general wounds and diabetic ulcer wounds in in vitro models of animals to provide a theoretical basis for clinical translation. Methods A total of 19 studies with 356 animals were identified by searching the PubMed, Cochrane, MEDLINE Complete, Web of Science, CNKI and Wanfang databases from inception to 15 November 2022. No language or time restrictions were applied. Stata17 was used for all the data analyses. Results The meta-analysis showed that ADSC-Exo therapy significantly improved the wound healing rate in the control group, except in the diabetes group on day 7. Day 7 of general wounds [standard mean difference (SMD) 2.87, 95% confidence interval (CI) 1.91–3.83)] and day 14 (SMD 2.89, 95%CI 1.47–4.30). Day 14 (SMD 3.43, 95%CI 1.28–5.58) of diabetic wounds. Other outcomes, such as blood vessel density, collagen deposition and wound re-epithelization, improved with the administration of ADSC-Exos. Conclusions A meta-analysis showed that ADSC-Exo therapy applied to general and diabetic wounds can promote neovascularization, improve epithelization and collagen fiber deposition, promote healing, and reduce scar formation. ADSC-Exos have broad potential in preclinical research and clinical fields.

中文翻译：

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脂肪干细胞衍生的外泌体在临床前动物模型伤口愈合治疗中的作用：荟萃分析


背景 伤口愈合一直是医生和初级卫生保健系统面临的一个严重问题。此外，脂肪干细胞来源的外泌体已被证明在组织修复和再生中发挥积极有效的作用。对这些临床前研究进行系统评价，以评估脂肪干细胞源性外泌体 (ADSC-Exos) 在治疗伤口方面的功效。本文旨在研究ADSC-Exos治疗动物皮肤伤口的有效性，并在动物体外模型中对一般伤口和糖尿病溃疡伤口的外泌体进行Meta分析，为临床转化提供理论依据。方法 通过检索PubMed、Cochrane、MEDLINE Complete、Web of Science、CNKI和万方数据库，从建库至2022年11月15日，共找到19项研究，涉及356只动物。没有语言或时间限制。 Stata17 用于所有数据分析。结果 荟萃分析显示，ADSC-Exo 疗法在第 7 天显着提高了对照组的伤口愈合率，但糖尿病组除外。一般伤口第 7 天[标准均差 (SMD) 2.87，95% 置信区间 ( CI）1.91–3.83）]和第14天（SMD 2.89，95%CI 1.47–4.30）。糖尿病伤口第 14 天（SMD 3.43，95%CI 1.28–5.58）。其他结果，如血管密度、胶原蛋白沉积和伤口上皮再生，随着 ADSC-Exos 的施用而得到改善。结论荟萃分析显示，ADSC-Exo疗法应用于一般伤口和糖尿病伤口可以促进新生血管形成，改善上皮化和胶原纤维沉积，促进愈合，减少疤痕形成。 ADSC-Exos 在临床前研究和临床领域具有广泛的潜力。