The Signaling Pathways Induced by Exosomes in Promoting Diabetic Wound Healing: A Mini-Review

Impaired healing of diabetic wounds harms patients' quality of life and even leads to disability and death, which is an urgent issue to be solved clinically. Despite the great progress that has been achieved, it remains a worldwide challenge to develop effective therapeutic treatments for diabetic wounds. Recently, exosomes have attracted special attention because they can be involved in immune response, antigen presentation, cell migration, cell differentiation, tumor invasion and other processes. Meanwhile, exosomes have been proven to hold great potential in the treatment of diabetic wounds. Mechanistic studies of exosomes based on signaling pathways could not only help to uncover the mechanisms by which exosomes promote diabetic wound healing but could also provide a theoretical basis for the clinical application of exosomes. Herein, our mini-review aims to summarize the progress of research on the use of various exosomes derived from different cell types to promote diabetic wound healing, with a focus on the classical signaling pathways, including PI3K/Akt, Wnt, NF-kappa B, MAPK, Notch, Nrf2, HIF-1 alpha/VEGF and TGF-beta/Smad. The results show that exosomes could regulate these signaling pathways to down-regulate inflammation, reduce oxidative stress, increase angiogenesis, promote fibroblast proliferation, induce re-epithelization and inhibit scar formation, making exosomes attractive candidates for the treatment of diabetic wounds.

Automated summary

Impaired healing of diabetic wounds is a significant problem that affects patients' quality of life and can lead to disabilities and death. Developing effective treatment options for diabetic wounds remains a global challenge. Exosomes have emerged as promising candidates for diabetic wound healing due to their involvement in immune response, cell migration, tumor invasion, and other processes. This mini-review summarizes the progress of research on various exosomes derived from different cell types and their role in promoting diabetic wound healing. The review also focuses on the classical signaling pathways that exosomes can regulate, providing insights into the mechanisms by which exosomes contribute to diabetic wound healing.