Fractional carbon dioxide laser preconditioning potentiates adipose-derived mesenchymal stem cell exosomes for diabetic wound repair

Figure 1 Schematic illustration of pre-conditioning strategies to enhance mesenchymal stem cells-derived secretomes for cutaneous wound healing. Mesenchymal stem cells (MSCs) are isolated from diverse tissue sources, including the umbilical cord, adipose tissue, bone marrow, and dermal tissue. To augment their therapeutic potential, MSCs are subjected to two main categories of pre-conditioning strategies: (1) Physical stimuli, including blue light radiation, electrical and magnetic stimulation, hypoxia, fractional carbon dioxide laser, ultrasound, and mechanical stimuli; and (2) Pharmacological agents, such as quercetin, curcumin, flavonoids, rapamycin, pioglitazone, empagliflozin, and atorvastatin. These interventions potentiate the secretion of bioactive products, including extracellular vesicles, exosomes, apoptotic bodies, and conditioned medium. Administration of these pre-conditioned secretomes accelerates wound healing by promoting extracellular matrix remodeling, angiogenesis, hair follicle regeneration, re-epithelialization, fibroblast proliferation/migration, and macrophage polarization. MSC: Mesenchymal stem cells; CO₂: Carbon dioxide.