Topical Human Mesenchymal Stem Cell-Derived Exosomes for Acceleration of Wound Healing Following Tissue Trauma and Aesthetic Procedures: A Case Series

April 2024 | Volume 23 | Issue 4 | 281 | Copyright © April 2024


Published online October 20, 2023

Marina Peredo a, Shanthala Shivananjappa b

aMount Sinai School of Medicine; Dermatologist in Private Practice at Skinfluence Medical PC, New York, NY
bShanthala MD Medspa and Laser Center, Peabody, MA

Abstract
Background: In the aesthetics practice, measures to accelerate wound healing and minimize downtime following procedures have been largely restricted to topical serums and platelet-rich plasma (PRP), which can have varying levels of success. Here, the authors present a case series of patients treated in clinical practice with cell-free exosomes derived from human placental mesenchymal stem cells (Exovex, Exocelbio, Doylestown, PA). Topical administration of exosomes after either aesthetic treatment or traumatic injury (a dog bite) had a marked effect on healing. Effects were assessed visually, and case-study images are shared. Individuals demonstrated significantly accelerated recovery and wound healing within hours to days, depending on the procedure. Patients who had undergone the same aesthetic procedure prior without exosomes reported satisfaction with reductions in pain, swelling, redness, and post-procedure downtime. No adverse events were reported by patients after treatment. Together, these case series suggest that exosome treatment can accelerate wound healing safely and effectively and support topical use in an office-based setting. These findings also highlight the need for more formal evaluation of the effects of exosomes on wound healing in reducing aesthetic procedure recovery times for surgical and non-surgical interventions.
Significant Finding: The case series presented here illustrates the potential for exosomes to be a versatile and important part of clinical care, especially in situations where expedited healing is central to patient safety and/or satisfaction. These results provide strong support for additional research. 
Meaning: Topical administration of cell-free exosomes has the potential to improve patient care and satisfaction with aesthetic interventions. Early experience, illustrated by the presented case studies, has been remarkably positive and treatment has the potential to dramatically improve the standard of care. 

J Drugs Dermatol. 2024;23(4):281-284. doi:10.36849/JDD.7395

INTRODUCTION

While surgical and non-surgical aesthetic technologies continue to evolve, there remains an unmet need for effective wound healing therapy in clinical practice. Although PRP has been widely and safely used in the clinic,1,2 there are multiple limitations to its use as a wound healing therapy, including its extensive collection and preparation process and potential for decreased effectiveness in more mature patients.3-5

Exosomes, also known as extracellular vesicles (EVs), are lipid bilayer membrane micro-vesicles secreted by almost all eukaryotic cells.6-8 Native exosomes target and repair damaged tissue at sites of inflammation through the delivery of lipids, proteins, and nucleic acids to recipient cells via paracrine signaling.7,8 Their contents may also include cell-signaling proteins and/or growth factors relevant to all four phases of wound healing. The safe use of exosomes derived from a variety of cell types has been extensively reported for numerous therapeutic applications and their anti-inflammatory and immunomodulatory properties are well documented.7,9 

The ability of exosomes to influence angiogenesis and the differentiation, proliferation, and apoptosis of target cells has made these micro-vesicles the subject of particular interest in wound healing and regenerative medicine.10 In addition, many studies have demonstrated a role for certain miRNAs in the promotion of scar removal, skin rejuvenation, pigmentation regulation, and hair growth.10 

MATERIALS AND METHODS

Exosome Source and miRNA Content
Cell-free exosomes were pre-clinically isolated from mesenchymal stem cells derived from human placental tissue according to good manufacturing practice (GMP) guidelines.7 
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