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Gene & Protein in Disease A review of exosome-mediated treatments

the over-activation of MMP-9 led to the degradation of severe or persistent acne that has not responded well
collagen and elastin, hindering diabetic foot ulcer healing. to other treatments. Using stem cell-derived exosomes
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However, exosomes can alter the ratio of MMP to its improved the appearance of acne scars and reduced the
inhibitors, thereby promoting a more balanced and healing post-treatment recovery period in patients treated with
environment. Furthermore, by regulating oxidative stress the combination therapy. In addition, exosomes’ anti-
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2
and encouraging tissue regrowth in hypoxic conditions, inflammatory effects may foster a microenvironment
exosomes further promote wound healing. They have also that decreases acne flare-ups, and their role in regulating
been shown to induce the M2 macrophage phenotype, a skin homeostasis through the PI3K/Akt pathway is
change that naturally occurs at a later stage of the healing currently under investigation. 52,53 Exosomes are also being
process, which promotes an immunosuppressive and explored for their application in pigmentation disorders,
anti-inflammatory environment. Reports have also a common type of dermatologic condition. The current
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shown that exosomes operate on certain inflammatory literature supports the therapeutic efficacy of exosomes in
signaling pathways, including TLR4, AKT/β-catenin, enhancing the epidermal-melanin unit, which describes
and transforming growth factor-β/SMAD signaling. 46,47 the relationship between melanocytes (cells that produce
These effects are primarily mediated through exosomes’ melanin) and keratinocytes (the predominant cells in the
paracrine signaling. epidermis). Keratinocytes naturally secrete exosomes to
Ultimately, the comprehensive examination of enhance melanin synthesis by increasing the signaling
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exosome efficacy in alopecia and wound healing not of melanosome proteins. Certain microRNAs, such as
only highlights the current state of research but also MiR203 and MiR145, have been identified to play a role in
underscores the potential transformative impact of regulating pigmentation by targeting tyrosinase expression
exosome-based therapies on dermatological treatments. and melanogenesis. 48
This multifaceted approach paves the way for innovative Currently an expanding field of research, exosomes
and effective interventions in clinical dermatology. In present an exciting, novel therapeutic approach for
addition, it is important to address that current research common dermatological conditions. Beyond the
regarding the role of exosomes in wound repair is still conditions discussed in this article, further applications are
evolving, with most studies focused on the cellular level being studied, including the role of exosomes in treating
and on animal models. While medical applications show other inflammatory conditions, such as psoriasis and
great promise, more clinical interventions and trials must atopic dermatitis, as well as their potential in diagnosing
be conducted to fully understand and utilize exosomes’ and treating skin cancer. 55-57
therapeutic potential. In addition, the exploration
of potential challenges, such as optimal dosages and 3. Safety assessment of exosome injections
timing of exosome administration, will contribute to
the development of standardized protocols for clinical 3.1. Risk of adverse events
applications. 3.1.1. In-depth analysis of potential concerns
2.2.3. Efficacy in other dermatological conditions As highlighted in previous sections, exosomes function
by delivering biomolecules derived from an original
Exosomes have shown great promise as an alternative donor cell, including proteins and RNA, to recipient
therapeutic agent for alopecias and wound healing, cells to modulate gene expression and cell signaling,
and their use is being investigated in a variety of other thereby affecting the overall function of the recipient
dermatological conditions, including skin photoaging, cell. In the healthy human body, this process is tightly
acne, and pigmentation disorders (Figure 2). Current regulated. Thus, there are concerns revolving around the
research illustrates the anti-senescence effect of exosomes efficacy and safety of exosomes as a treatment modality,
in rejuvenating aging skin by delivering growth factors, given their effects on cellular behavior. Current concerns
microRNA, and other bioactive molecules to promote include the potential of exosomes to cause genomic
dermal fibroblast activity, collagen production, and skin instability and cancer. In addition, the delivery method of
elasticity. 48-50 In addition, studies have demonstrated the
efficacy of bovine milk-derived exosomes in maintaining exosomes, including dermal injections, raises questions
the skin barrier, preserving moisture, and reducing about their local and systemic effects, as well as any off-
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the appearance of wrinkles. The efficacy of exosomes target impacts.
has also been studied in acne patients. ADSC-Exos Exosomes have gained attention over the past decade
was used in patients as an adjunct therapy after carbon due to the great promise held by this novel modality in
dioxide laser therapy, which is most commonly used for regenerative medicine; however, the United States food

Volume 3 Issue 2 (2024) 7 doi: 10.36922/gpd.3230