Exosome Therapy for Chronic Wound Healing.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Chronic lower-extremity ulcers linked to diabetes, venous insufficiency, or smoking are difficult to heal because of impaired vascularity, persistent inflammation, and extracellular matrix dysfunction. Exosome therapy-a cell-free regenerative approach-may address these deficits by delivering proangiogenic and immunomodulatory cargo. We evaluated its clinical usage in a case series. Four adults (age 42-62 y) with ulcers present for 6 months or more and refractory to compression, debridement, and topical care received monthly topical applications of adipose-derived stem-cell exosomes (Exo-HL, Primoris International Co., Ltd., Seoul, Korea), 1 × 10 12 particles/mL; 0.1 mL/cm 2 wound area). Wounds were photographed and measured every 2-4 weeks; Doppler ultrasonography quantified arterial resistive index and venous reflux at baseline and 3-month intervals. Follow-up continued for up to 7 months. Median baseline ulcer area was 12.4 cm² (range, 4.8-26.1 cm²). All wounds showed visible granulation within 2 weeks; 3 achieved complete closure after a median of 94 days (range, 60-180 d). Mean arterial resistive index decreased from 0.93 ± 0.04 to 0.77 ± 0.03, and venous reflux time fell from 2.8 ± 0.3 to 1.4 ± 0.2 seconds. No adverse events or wound infections occurred. Exosome therapy was well tolerated and associated with rapid granulation, improved perfusion, and durable closure of ref

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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