Exosomal peptides and proteins in wound healing and skin regeneration

Wound healing is a highly coordinated biological process that includes inflammation, angiogenesis, proliferation, and tissue remodeling. Chronic wounds, comprising diabetic foot ulcers as well as pressure ulcers, present significant healthcare challenges due to prolonged healing and susceptibility to infections. Traditional treatments often fail to modulate the wound microenvironment, leading to suboptimal outcomes. Recent advancements highlight the potential of exosomal peptides and proteins in enhancing skin regeneration and wound repair. Exosomes are extracellular vesicles released by various cells, containing bioactive molecules like proteins, peptides, growth factors, and microRNAs, which regulate wound healing. Exosomal proteins contribute to angiogenesis by stimulating vascular endothelial growth factor and transforming growth factor-β, while heat shock proteins and matrix metalloproteinases facilitate extracellular matrix remodeling. Exosomal peptides and proteins offer a promising cell-free method for enhancing the healing of wounds and the regeneration of the skin. The present review sheds light on the therapeutic possibilities of exosomal peptides and proteins in wound healing, focusing on their mechanisms, biological effects, clinical applications, and challenges along with their future.