Review
Copyright ©The Author(s) 2022.
World J Diabetes. Dec 15, 2022; 13(12): 1066-1095
Published online Dec 15, 2022. doi: 10.4239/wjd.v13.i12.1066
Table 1 Mesenchymal stem cell-derived exosomes application of diabetic full-thickness acute/chronic cutaneous wounds model
No.
Ref.
Institution(Nation)
Exosomes source
Intervention, administration, dose and time
Control
Model species
Wound diameter
Therapeutic effect
Molecular mechanism
1Yang et al[140], 2020The Third Affiliated Hospital of Southern Medical University(China)Human umbilical cord 1 HUCMSC-Exos + PF-127 hydrogel; injected topically; 100 µg in 100 µL PF-127 (24%); at Day 0PBS (100 µL)Rats (Sprague-Dawley)10 mm × 2 (1.5 cm apart)1 Accelerated wound closure rate
2 New hair follicle formation, fibroblasts proliferation, sufficient and order collagen deposition
2 HUCMSC-Exos + PF-127 hydrogel; injected topically; 100 µg in 100 µL PBS; at Day 0
3 Reduced inflammatory cell infiltration
4 Higher microvessel densities and higher number of blood vessels (CD31, MVD)
3 PF-127 hydrogel; injected topically; 100 µL PF-127 (24%); at Day 0
5 Promoted cell proliferation (Ki67) and enhanced regeneration of granulation tissue
6 Upregulated expression of VEGF and TGF-β
7 Hydrogel supported exosome survival and biological activity
2Wang et al[141], 2019The Affiliated Hospital of Wenzhou Medical University; Xi'an Jiaotong University(China)Mouse adipose tissue1 AMSC-Exos + F127/OHA-EPL hydrogel; covered the wound; 10 μg; at Day 0SalineMice (ICR)8 mm × 2 mm1 Accelerated wound closure rates
2 Promoted cell proliferation and abundant granulation tissue in early stage of healing; reduced proliferative activities during the late repair stage to prohibit tissue hyperplasia
2 AMSC-Exos; covered the wound; 10 μg; at Day 0
3 Abundant and well-organized collagen fibers, more collagen deposition (Col I, Col III)
3 F127/OHA-EPL hydrogel; covered the wound; 10 μg; at Day 0
4 Faster re-epithelization (cytokeratin) and epithelial cell differentiation
5 Promoted angiogenesis (α-SMA) and blood vessels formation
6 Complete skin regeneration: skin appendages and less scar tissue appeared
3Liu et al[121], 2020Second Military Medical University; Shanghai Sixth People’s Hospital affiliated to Shanghai Jiao Tong University(China)Human bone marrow1 Melatonin-pretreated BMSC-Exos (MT-Exo); injected subcutaneously at least six sites per wound; dose not mentioned; at Day 0PBSRats (Sprague-Dawley)20 mm1 Accelerated diabetic wound healingPTEN/AKT signaling pathway
2 Anti-inflammatory effect on macrophages by promoting M2 and inhibiting M1 polarization
3 Enhanced re-epithelialization (increased neoepithelium length)
4 Improved angiogenesis (α-SMA, CD31, Microfli perfusion) and collagen synthesis (Col I and III)
5 Activated the PTEN/AKT signaling pathway
2 BMSC-Exos; injected subcutaneously at least six sites per wound; dose not mentioned; at Day 0
4Pomatto et al[104], 2021University of Turin(Italy)Human bone marrowBMSC-EVs + carboxymethylcellulose; applied on the wound; 1 × 109 in 25 µL of vehicle; at Day 0, 3, 7 and 10carboxymethylcellulose high viscosity 10 mg/mL (25 µL)Mice (NSG)6 mm × 8 mmNot effective and did not reduce the wound closure rate
Human adipose tissueAMSC-EVs + carboxymethylcellulose; applied on the wound; 1 × 109 in 25 µL of vehicle; at Day 0, 3, 7, 10 and 141 Accelerated cutaneous wound healing
2 Reduced size of the scar
3 Increased epithelial thickness and re-epithelization
4 Promoted angiogenesis (the number of vessels)
5Shi et al[139], 2020Affiliated Hospital of Nantong university(China)Human adipose tissue1 mmu_circ_0000250-modified AMSC-Exos;injected subcutaneously at four sites around the wound;200 μg in 100 μL PBS;at Day 0PBS (100 μL)Mice (C57BL)4 mm1 Accelerated cutaneous wound healingmmu_circ_0000250/miR-128-3p/SIRT1-mediated autophagy
2 Reduced scar areas
3 Enhanced angiogenesis (CD31, vessel density)
4 Suppressed apoptosis of skin tissue
5 Suppressed expression of miR-128-3p but promoted SIRT1 expression
2 AMSC-Exos; injected subcutaneously at four sites around the wound; 200 μg in 100 μL PBS; at Day 0
6 Increased expression of autophagy-related gene (LC3)
6Hu et al[138], 2021Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology(China)Rat bone marrow1 Pioglitazone-treated BMSC-Exos (PGZ-Exos); injected subcutaneously(at least six sites per wound); 100 μg in 100 μL PBS; at Day 0PBS (100 μL)Rats (Sprague-Dawley)15 mm1 Accelerated cutaneous wound healingPTEN/PI3K/AKT/eNOS pathway
2 Enhanced re-epithelization
3 Promoted collagen synthesis (Col I, Col III) and collagen deposition, indicating more superior ECM remodeling ability
4 Enhanced angiogenesis (VEGF, CD31) and blood flow of the wound
2 BMSC-Exos; injected subcutaneously (at least six sites per wound); 100 μg in 100 μL PBS; at Day 0
7Yu et al[137], 2020Shanghai Sixth People’s Hospital affiliated to Shanghai Jiao Tong University; Second Military Medical University(China)Human bone marrow1 Atorvastatin-pretreated BMSC-Exos (ATV-Exos); injected subcutaneously (six points); dose not mentioned; at Day 0PBSRats (Sprague-Dawley)20 mm1 Accelerated cutaneous wound healingmiR-221-3p /PTEN/AKT/eNOS pathway
2 Increased re-epithelization (more epithelial structures and longer neuroepithelium)
2 BMSC-Exos; injected subcutaneously (six points); dose not mentioned; at Day 0
3 Promoted collagen synthesis and deposition, indicating more superior ECM remodeling ability (thicker wavy collagen fibers and more extensive collagen deposition arranged neatly)
4 Superior biosafety of the therapy of exosomes
5 Enhanced angiogenesis (CD31, α-SMA and Microfil perfusion)
8Zhao et al[123], 2021Tongji University(China)Human adipose tissue1. AMSC-Exos; smeared at the wound; 200 μg in 200 μL PBS; 3 times/day, 2 wkPBS;UntreatedMice (db/db)15 mm1 Accelerated cutaneous wound healing
2 Exosomes entered the dermis of wounds after smearing
2 Recombinant human epidermal growth factor (rhEGF); smeared at the wound;3 times/day, 2 wk
3 Mild hyperkeratosis and typical fibrous structures with new glands and hair follicles, implying enhanced tissue remodeling
3 AMSC-CM; smeared at the wound; 3 times/day, 2 wk
4 Enhanced collagen synthesis (Col I, Col III), deposition and remodeling (large amounts, large area, regular arrangement and dense distribution of new collagen)
5 Enhanced cell proliferation and inhibited apoptosis
6 Increased blood vessel intensity and promoted angiogenesis (CD31, VEGF)
7 Repaired skin barrier functions (elevated expression levels Filaggrin, Loricrin, and AQP3)
8 Suppressed expression of inflammatory cytokines (IL-6, TNF-α, CD14, CD19 and CD68)
9 Negatively regulated MMP1 and MMP3 expression in promoting collagen synthesis
9Tao et al[150], 2017Shanghai Jiao Tong University Affiliated Sixth People’s Hospital(China)Human synovial membrane1 miR-126-3p overexpressed SMSC-Exos + chitosan wound dressings; placed on the wound bed with pressure dressing; at Day 0UntreatedRats (Sprague-Dawley)18 mm1 Accelerated cutaneous wound healingPI3K/AKT and MAPK/ERK signaling pathways
2 Enhanced angiogenesis (microcomputed tomography, CD31, α-SMA)
3 Promoted re-epithelialization, granulation tissue formation, collagen alignment and deposition, implying enhanced ECM remodeling
2 Chitosan wound dressings; placed on the wound bed with pressure dressing; at Day 0
4 Accelerated development of hair follicles and sebaceous glands
10Ti et al[126], 2015Chinese PLA General Hospital(China)Human umbilical cord 1 LPS-pretreated HUCMSC-Exos; injected dispersively into the wound edge; 60 μg in 0.5 mL PBS; at Day 0UntreatedRats10 mm1 Accelerated cutaneous wound healinglet-7b/TLR4/NF-κB/STAT3/AKT pathway
2 Decreased inflammatory cell infiltration
3 Regulate macrophage polarization to M2 macrophages
2 HUCMSC-Exos; injected dispersively into the wound edge; 60 μg in 0.5 mL PBS; at Day 0
4 Promoted the appearance of new small capillaries
11Li et al[136], 2020The Fourth Affiliated Hospital of Harbin Medical University(China)Mouse bone marrow1 lncRNA H19 overexpressed BMSC-Exos; injected into the skin around the wound; at Day 0UntreatedMice (C57BL/6)10 mm1 Accelerated cutaneous wound healing.lncRNA H19/miR-152-3p/PTEN/ PI3K/AKT signaling pathway
2 Ameliorated inflammation of the wound (IL-10 ↑, IL-1β↓, TNF-α↓ and fewer inflammatory cells around the wound)
2 BMSC-Exos; injected into the skin around the wound; at Day 0
3 Promoted granulation tissue formation
4 Enhanced angiogenesis (Increased expression of VEGF, TGF-β1, α-SMA, and Col I)
5 Suppressed cell apoptosis
6 Interacted with miR-152-3p via PTEN-mediated PI3K/AKT signaling pathway (diminished miR-152-3p expression, elevated PTEN expression and decreased expression of PI3K, AKT and p-AKT)
12Shi et al.(2017)[142]Chinese PLA General Hospital(China)Human gingival tissue1 GMSC-Exos+ chitosan/silk hydrogel sponge; covered the wound with restraining bandage; 150 μg in 100 μl PBS; at Day 0, changed every 3 d1. PBS (100 μL);2. gauze (13 mm× 13 mm) covered the woundRats (Sprague-Dawley)10 mm1 Accelerated cutaneous wound healing
2 Promoted re-epithelialization, deposition and remodeling of ECM (more collagen deposition and thick wavy collagen fibers, the collagen fibers arranged in an orderly fashion similar to that of normal skin)
2 Chitosan/silk hydrogel sponge; covered the wound with restraining bandage; in 100 μL PBS; at Day 0, changed every 3 d
3 Enhanced angiogenesis (CD34, microvessel density)
4 Enhanced neuronal ingrowth (nerve fiber density)
13Xiao et al[151], 2021Nan Fang Hospital of Southern Medical University(China)Human adipose tissue1 AMSC-Exos + human acellular amniotic membrane (hAAM) scaffold; covered on the wound; 100 μg in 100 μL PBS; at Day 0, every other day, 3 times in totalPBS (100 μL)Mice (BALB/c)10 mm1 Accelerated cutaneous wound healing
2 Suppressed wound inflammatory responses (fewer inflammatory cells around the wound and higher recruitment of M2 macrophages to the wound sites)
2 AMSC-Exos; covered on the wound;100 μg in 100 μL PBS; at Day 0, every other day, 3 times in total
3 Enhanced angiogenesis (CD31)
4 Enhanced extracellular matrix (ECM) deposition (Col III)
5 Promoted re-epithelialization (completed epithelial and dermal regenerated)
3 hAAM patch; covered on the wound; at Day 0, every other day, 3 times in total
6 Failed regenerated hair follicle and sebaceous glands
14Yan et al[152], 2022Union Hospital, Tongji Medical College, Huazhong University of Science and Technology(China)Human umbilical cord 1 HUCMSC-Exos injected locally to the wound site; 100 μL, 50 μg/ml; at days 0, 3, 5, 7, 9, and 11PBS (100 μL)Mice (C57BL/6J)10 mm1 Accelerated cutaneous wound healing
2 Reduced oxidative stress (ROS)
3 Promoted granulation tissue formation
2 HUCMSC-Exos injected locally to the wound site; 100 μL, 100 μg/mL; at days 0, 3, 5, 7, 9, and 11
4 Enhanced angiogenesis (CD31, mean perfusion unit ratio)
15Geng et al[128], 2022Jinzhou Medical University(China)Rat bone marrow1 BMSC-Exos + carboxyethyl chitosan-dialdehyde carboxymethyl cellulose hydrogel; covered the wound; twice a day, two weeksUntreatedRats (Sprague-Dawley)20 mm1 Accelerated cutaneous wound healingVEGF-mediated PI3K/AKT signaling pathways
2 Promoted collagen deposition and remodeling, and fibrin regeneration
2 Carboxyethyl chitosan-dialdehyde carboxymethyl cellulose hydrogel; covered the wound; twice a day, two weeks3 Enhanced antibacterial effects by significantly inhibiting bacterial growth
4 Skew macrophage functional polarity from M1 (iNOS) towards an anti-inflammatory M2 phenotype (CD206)
5 Decreased inflammatory factors (IL-1β, TNF-α)
6 Promoted proliferation of blood vessels and angiogenesis (CD31)
16Gondaliya et al[153], 2022National Institute of Pharmaceutical Educationand Research(India)Bone marrow1 BMSC-Exos loaded with miR-155 inhibitor; injected subcutaneously; 0.1 μg/μL; 1 d after wound inductionUntreatedMice (C57BL/6)4 mm1 Accelerated cutaneous wound healing
2 Declined miR-155 levels with a concomitant increase in FGF-7
2 BMSC-Exos; injected subcutaneously; 0.1 μg/μL; 1 d after wound induction
3 Downregulated expression of MMP-2 and MMP-9
4 Declined expression of pro-inflammatory cytokines (TIMP-2, lymphotactin, sTNF RI, sTNF RII, and LIX); declined regulated upon activation, normal T cell expressed and secreted (RANTES) chemokine; downregulated pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) and TGF-β1
3 BMSC-Exos loaded with negative control sequences; injected subcutaneously; 0.1 μg/μL; 1 d after wound induction
5 Promoted re-epithelialization, collagen synthesis and deposition, angiogenesis (α-SMA) and vascularization (CAM)
17Dalirfardouei et al[125], 2019Mashhad University of Medical Sciences(Iran)Human menstrual blood1 MenSC-Exos; injected intradermally; 10 μg in 100 μL of PBS; at Day 0PBS (100 μL)Mice (C57BL/6)8 mm1 Accelerated cutaneous wound healingNF-κB signaling pathway (possible)
2 Promoted re-epithelialization
2 MenSCs; injected intradermally; 1 × 106 cells in 100 μL of PBS; at Day 0
3 Induced macrophage polarization from M1 (iNOS) to M2 (Arg) phenotype
4 Enhanced angiogenesis (VEGF, microvessel density)
5 Improved collagen deposition (upregulated Col I/Col III ratio at Day 7, downregulated at Day 14)
6 Decreased size of scar tissues
7 Decreased cellularity in the granulation tissue
8 Decreased Rela gene expression at Day 4, enhanced at Day 7.
18Wang et al[124], 2022Affiliated Hospital of Nantong University(China)Rat bone marrow1 BMSC-Exos + 50 mg/kg intraperitoneal tertbutylhydroquinone (tBHQ); injected subcutaneously of 4 sites at the base and edge of the wound; 100 μg/mL, 200 μL; at Day 0 and 7PBSRats (Sprague-Dawley)15 mm1 Accelerated cutaneous wound healing
2 Promoted re-epithelialization and collagen deposition
3 Enhanced angiogenesis (CD31)
4 Reduced inflammation (decreased inflammatory cytokines TNF-α, IL-1β and increased anti-inflammatory cytokines IL-4, IL-10).
2 BMSC-Exos + 200 μL intravenous Lenti-sh-NC; injected subcutaneously of 4 sites at the base and edge of the wound; 100 μg/mL, 200 μL; at Day 0 and 7
3 BMSC-Exos; injected subcutaneously of 4 sites at the base and edge of the wound; 100 μg/mL, 200 μL; at Day 0 and 7
4 BMSC-Exos + 200 μL intravenous Lenti-sh-Nrf2; injected subcutaneously of 4 sites at the base and edge of the wound; 100 μg/mL, 200 μL; at Day 0 and 7
19Sun et al[127], 2022Nanjing Normal University; Nanjing University; Nanjing medical University; Nanjing Tech University(China)Human umbilical vein1 Engineering TNF-α/hypoxia-pretreated HUVMSC-Exos +PCOF; each subsequent day later, total 21 dPBSMice (C57BL/6)15 mm (S.aureus-infected chronic wounds)1 Accelerated cutaneous wound healingmiR-126/ SPRED1/RAS/ERK pathway (possible)
2 Reduced bacterial burden and suppressed bacterial colonization in the wound sites
2 Engineering TNF-α/hypoxia-pretreated HUVMSC-Exos; each subsequent day later, total 21 d
3 Reduced the inflammatory response (immune cells counting); decreased proinflammatory cytokines (TNF-α, IL-1β, IL-6); induced M2 (CD206) macrophages polarization
3 Vancomycin; each subsequent day later, total 21 d
4 PCOF; each subsequent day later, total 21 d
4 Promoted collagen deposition and remodeling, granulation formation, re-epithelialization and enhanced proliferation of fibroblasts
5 Enhanced cell proliferation (Ki67)
6 Suppressed oxidative stress induced by bacteria and peroxide substrates (reduced the content of oxidative biomarkers and (MDA) increased the antioxidant mediators (GSH-Px, SOD)
7 Promoted angiogenesis (upregulated miR-126, HIF-1α, VEGF, CD31 and α-SMA; increased neovascularization)
8 In vivo biosafety (blood system, heart, liver, kidney and other organs)
20Li et al[147], 2016Shanghai Normal University; Shanghai Jiao Tong University Affiliated Sixth People's Hospital(China)Human synovial tissue1 miR-126-3p overexpressed SMSC-Exos + hydroxyapatite/chitosan composite hydrogel; placed on the wound bed with pressure dressingUntreatedRats (Sprague-Dawley)18 mm1 Accelerated cutaneous wound healingActivated MAPK/ERK and PI3K/AKT pathways
2 Enhanced angiogenesis (μCT), formation and maturation of new vessels (CD31, α-SMA)
3 Promoted re-epithelialization, granulation tissue maturation, collagen alignment and deposition that indicated improved ECM remodeling
2 Hydroxyapatite/chitosan composite hydrogel; placed on the wound bed with pressure dressing
4 Accelerated growth of follicles and sebaceous glands
21Zhang et al[148], 2021Jinzhou Medical University(China)Human umbilical cord1 HUCMSC-Exos + polyvinyl alcohol (PVA)/alginate (Alg) nanohydrogel; locally transplanted; 300 μL; once a dayUntreatedRats (Sprague-Dawley)15 mm × 2 mm1 Accelerated cutaneous wound healingERK1/2 pathway
2 Enhanced re-epithelialization and hair follicles formation
3 Promoted collagen deposition and remodeling (increased and orderly arranged collagen fibers)
2 HUCMSC-Exos; locally transplanted; 300 μL; once a day
3 PVA/Alg nanohydrogel; locally transplanted; 300 μL; once a day
4 Promoted angiogenesis (CD31, α-SMA, SR-B1, VEGF)
22Han et al[154], 2022The First Affiliated Hospital of Zhengzhou University(China)Human bone marrow1 lncRNA KLF3-AS1 overexpressed BMSC-Exos; injected via tail vein; 100 µL; at Day 0UntreatedMice (BALB/c)Not mentioned1 Accelerated cutaneous wound healinglncRNA KLF3-AS1/miR-383/VEGFA signaling pathway
2 Minimized weight loss.
2 Negative control silenced BMSC-Exos;injected via tail vein;100 µL;at Day 03 Reduced inflammation (decreased IL-6 and IL-1β)
4 Promoted angiogenesis (CD31), collagen deposition and follicle regeneration
3 Negative control overexpressed BMSC-Exos; injected via tail vein; 100 µL; at Day 0
5 Decreased expression of miR-383 and increased VEGFA
4 lncRNA KLF3-AS1 silenced BMSC-Exos; injected via tail vein; 100 µL; at Day 0
23Ding et al[155], 2019Shanghai Jiao Tong University Affiliated Sixth People's Hospital(China)Human bone marrow1 Deferoxamine-preconditioned BMSC-Exos (DFO-Exos); injected subcutaneously around the wounds at four sites; 100 μg in 100 μL PBS; at Day 0PBS (100 μL)Rats (Sprague-Dawley)20 mm × 2 mm1 Accelerated cutaneous wound healingmiR-126/PTEN/PI3K/AKT pathway
2 Enhanced re-epithelialization and lower scar formation
3 Promoted collagen deposition (increased wavy collagen fibers)
2 BMSC-Exos; injected subcutaneously around the wounds at four sites; 100μg in 100μL PBS; at Day 0
4 Promoted angiogenesis (vessel density by micro-CT, CD31, α-SMA)
24Bian et al[135], 2020Chinese PLA General Hospital(China)Human deciduadMSC-sEVs; injected around the wounds at 4 sites (25 μL per site); 100 μL, 5.22 × 1011 particles/mL; at Day 7, 14, 21and 28PBS (100 μL)Mice (BKS-db)16 mm1 Accelerated cutaneous wound healingRAGE/RAS; Smad pathways
2 Reduced scar width
3 Accelerated collagen deposition (larger and better-organized collagen deposition)
4 Enhanced fibroblast proliferation (PCNA), migration (CXCR4), and differentiation abilities of fibroblast
5 Promoted angiogenesis (α-SMA)
6 Improved fibroblast senescent state (p21)
25Zhang et al[156], 2022Xijing Hospital of Fourth Military Medical University(China)Human adipose tissueAMSC-Exos; injected subcutaneously; 200 μg; 3 d after wound induction, for three consecutive daysPBS (100 μL)Mice (db/db)10 mm1 Accelerated cutaneous wound healingSIRT3/SOD2 pathway
2 Enhanced re-epithelialization
3 Promoted angiogenesis (CD34, VEGF)
4 Improved oxidative stress (MDA, T-AOC, SOD)
5 Reduced inflammatory cytokines (IL-1β, IL-6, TNF-α, MCP-1)
26Born et al[157], 2021University of Maryland; Johns Hopkins University School of Medicine(USA)Human bone marrow1 HOX transcript antisense RNA (HOTAIR) overexpressed BMSC-EVs; injected around the wound in a cross pattern of four sites; 50 μg in 50 μL PBS; at Day 3, four timesPBS (50 μL)Mice (db/db)8 mm1 Accelerated cutaneous wound healing
2 Promoted angiogenesis (CD31, VEGFA)
2 BMSC-EVs; injected around the wound in a cross pattern of four sites; 50 μg in 50 μL PBS; at Day 3, four times
27Teng et al[158], 2022Jiangnan University (China)Human umbilical cordHUCMSC-Exos; injected subcutaneously around the wounds at four sites; 100 μL (100 μg/mL); at Day 0PBS (100 μL)Rats (Sprague-Dawley)10 mm1 Accelerated cutaneous wound healing
2 Inhibited chronic inflammation: (decreased number of inflammatory cells); inhibited pro-inflammatory cytokines (TNF-α); induced M2 (CD206) macrophages polarization
3 Enhanced re-epithelialization
4 Promoted angiogenesis (increased new blood vessels, CD31, VEGF)
5 Promoted collagen synthesis and skin regeneration
Table 2 Clinical trials of exosomes in treating various wounds
Start year
Institution (Nation)
Type of wounds
Intervention
Autologous/Allogeneic
Administration, frequency
Patients number
Follow-up period
Outcome measures
Phase
Study design
ClinicalTrials.gov identifier
Status
2022Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University (China)Full-layer skin woundsAdipose tissue derived exosomes(200-300 mL of the subject adipose tissue)AutologousApplied directly to the wound (mixed with sterile hydrogel), twice a week54 wkPrimary: Percentage of wound healingNot ApplicableNon-randomized, single group assignment, open labelNCT05475418Not yet recruiting
2015Kumamoto University (Japan)Intractable cutaneous ulcers (e.g., rheumatic disease, peripheral arterial disease, chronic venous insufficiency, decubitus or burns)Plasma-derived exosomes (Plasma samples will be filtered through 0.45 μm and 0.20 μm filters. The samples will be filtered through 0.02 μm filter to trap exosomes with the filter. Saline solution will be loaded from the other side of the 0.02 μm filter to obtain exosome rich buffer.)AutologousApplied to the ulcer, daily528 dPrimary: Ulcer size (length, width, depth)Early Phase 1Non-randomized, single group assignment, open labelNCT02565264Unknown
Secondary: Pain of cutaneous wounds (VAS)
2023Aegle Therapeutics (USA)Dystrophic Epidermolysis Bullosa (DEB); chronic wounds (< 20% closure of wound during observation period); 10-50 cm2Bone marrow mesenchymal stem cells derived extracellular vesicle (AGLE-102)AllogeneicMultiple administrations of 2 ascending dose levels of AGLE-102; (up to 6 administrations); (each administration will occur 14 ± 7 d but no less than 7 d apart); (each administration no more than 3 mo); (wound closes prior to 6 administrations, no additional doses will be given)108 mo; if the wound closes before receiving all 6 doses, for 4 mo after the wound closesPrimary: Dose limiting toxicityPhase 1/2Non-randomized, multicenter, ascending dose, single group assignment, open labelNCT04173650Not yet recruiting
Secondary: Wound size
2019Mayapada Hospital (Indonesia)Chronic woundsHuman Wharton's Jelly mesenchymal stem cells conditioned medium (WJ-MSC-CM)AllogeneicApplied to the wound (the conditioned medium gel), every week382 wkPrimary: Success rate of chronic ulcer healingPhase 1Non-randomized, single group assignment, open labelNCT04134676Completed