Liang ZY, Hu HS. Letter to the Editor: Extracellular vesicles in diabetic bladder dysfunction - a promising cell-free therapeutic avenue from amniotic fluid stem cells. World J Stem Cells 2026; 18(7): 117525 [DOI: 10.4252/wjsc.117525]
Corresponding Author of This Article
Zhuo-Yin Liang, MD, Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, No. 151 Yanjiang West Road, Guangzhou 510120, Guangdong Province, China. emeyou@163.com
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Andrology
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letter
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Liang ZY, Hu HS. Letter to the Editor: Extracellular vesicles in diabetic bladder dysfunction - a promising cell-free therapeutic avenue from amniotic fluid stem cells. World J Stem Cells 2026; 18(7): 117525 [DOI: 10.4252/wjsc.117525]
World J Stem Cells. Jul 26, 2026; 18(7): 117525 Published online Jul 26, 2026. doi: 10.4252/wjsc.117525
Letter to the Editor: Extracellular vesicles in diabetic bladder dysfunction - a promising cell-free therapeutic avenue from amniotic fluid stem cells
Zhuo-Yin Liang, Hai-Sheng Hu
Zhuo-Yin Liang, Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Hai-Sheng Hu, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Co-first authors: Zhuo-Yin Liang and Hai-Sheng Hu.
Author contributions: Liang ZY and Hu HS contributed equally to this manuscript and are co-first authors. Hu HS designed the overall concept and outline of the manuscript; Liang ZY contributed to the writing and editing of the manuscript and illustrations of the literature. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Zhuo-Yin Liang, MD, Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, No. 151 Yanjiang West Road, Guangzhou 510120, Guangdong Province, China. emeyou@163.com
Received: December 10, 2025 Revised: January 16, 2026 Accepted: February 12, 2026 Published online: July 26, 2026 Processing time: 227 Days and 4.1 Hours
Abstract
In this letter, we comment on the article by Liang et al for their innovative study demonstrating the therapeutic potential of human amniotic fluid stem cell-derived extracellular vesicles (EVs) in improving bladder dysfunction in a rat model of diabetic atherosclerosis. The work highlights the ability of human amniotic fluid stem cell-derived EVs to restore urodynamic parameters, reduce systemic metabolic disturbances and arterial wall thickness, and modulate key inflammatory and fibrotic pathways, such as tumor necrosis factor-α, interleukin-6, and the transforming growth factor-β/Smad axis. In clinical urology, the relevance of this cell-free approach is emphasized, which offers a promising alternative to traditional stem cell therapies by mitigating the risks of tumorigenicity and immunogenicity. Although further validation of the mechanisms and optimization of dosing regimens are required, this study represents a considerable step toward developing regenerative strategies for diabetic bladder dysfunction and encourages translational research into EVs-based therapies for urological applications.
Core Tip: This letter examines the transformative potential of stem cell-derived extracellular vesicles as a novel cell-free regenerative strategy for diabetic bladder dysfunction. This underscores their unique capacity to simultaneously modulate urodynamic function, systemic metabolism, and local inflammatory-fibrotic pathways, thereby addressing the multifactorial pathogenesis of the condition. Representing a shift from symptomatic management to disease modification, extracellular vesicles offer a favorable safety profile and enhanced translational feasibility compared with whole-cell therapies. This discussion further outlines the critical steps for clinical integration, including cargo optimization, manufacturing standardization, and combination with postoperative rehabilitation.
