MSC/MSC-EV therapy for chronic wounds: microenvironmental reprogramming, product design, and clinical translation
- 1State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Post-Anesthesia Care Unit, West China Hospital of Stomatology, Sichuan University , , ,
- 2State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Dental Emergency and General Dentistry, West China Hospital of Stomatology, Sichuan University , , ,
Abstract
Chronic wounds are sustained not by a simple delay in the normal repair sequence, but by a hostile tissue microenvironment—persistent ischemia, non-resolving inflammation, proteolytic matrix degradation, oxidative stress, microbial burden, and senescence collectively form a self-reinforcing network that limits the effectiveness of conventional dressings and single-target interventions. Mesenchymal stromal cells (MSCs) and MSC-derived extracellular vesicles (MSC-EVs) are increasingly viewed not as replacement cells, but as transient, adaptive modulators of this pathological niche; their therapeutic effects are mediated largely through paracrine and vesicle-based signaling, which can recalibrate macrophage and T-cell responses, support angiogenesis, restore extracellular matrix homeostasis, protect resident keratinocytes and fibroblasts, and attenuate oxidative and infectious stress. This review reframes MSC-based therapy for chronic wounds as a product-design problem, synthesizing current evidence from wound biology, MSC and MSC-EV mechanisms, biomaterial-assisted delivery, source selection, potency testing, and early clinical studies, and argues that successful translation will depend on indication-matched products that couple defined biological potency with engineered delivery systems, clinically meaningful endpoints, patient stratification, and regulatory-ready manufacturing controls.
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BibTeX
@article{xiong2026mscmscev,
title = {{MSC/MSC-EV therapy for chronic wounds: microenvironmental reprogramming, product design, and clinical translation}},
author = {Maojing Xiong and Yutao Xiong and Wanqing Xie and Lu Yang and Bo Yang},
journal = {Frontiers in bioengineering and biotechnology},
year = {2026},
month = oct,
doi = {10.3389/fbioe.2026.1960442},
url = {https://europepmc.org/article/PMC/PMC13725077},
note = {CC BY},
}
RIS
TY - JOUR
TI - MSC/MSC-EV therapy for chronic wounds: microenvironmental reprogramming, product design, and clinical translation
AU - Maojing Xiong
AU - Yutao Xiong
AU - Wanqing Xie
AU - Lu Yang
AU - Bo Yang
PY - 2026
DA - 2026/10/19
JO - Frontiers in bioengineering and biotechnology
DO - 10.3389/fbioe.2026.1960442
UR - https://europepmc.org/article/PMC/PMC13725077
AB - Chronic wounds are sustained not by a simple delay in the normal repair sequence, but by a hostile tissue microenvironment—persistent ischemia, non-resolving inflammation, proteolytic matrix degradation, oxidative stress, microbial burden, and senescence collectively form a self-reinforcing network that limits the effectiveness of conventional dressings and single-target interventions. Mesenchymal stromal cells (MSCs) and MSC-derived extracellular vesicles (MSC-EVs) are increasingly viewed not as replacement cells, but as transient, adaptive modulators of this pathological niche; their therapeutic effects are mediated largely through paracrine and vesicle-based signaling, which can recalibrate macrophage and T-cell responses, support angiogenesis, restore extracellular matrix homeostasis, protect resident keratinocytes and fibroblasts, and attenuate oxidative and infectious stress. This review reframes MSC-based therapy for chronic wounds as a product-design problem, synthesizing current evidence from wound biology, MSC and MSC-EV mechanisms, biomaterial-assisted delivery, source selection, potency testing, and early clinical studies, and argues that successful translation will depend on indication-matched products that couple defined biological potency with engineered delivery systems, clinically meaningful endpoints, patient stratification, and regulatory-ready manufacturing controls.
SN - 2296-4185
ER -