外泌体在糖尿病足溃疡修复中的研究进展
Research Progress on Exosomes in the Healing of Diabetic Foot Ulcers
DOI: 10.12677/acm.2026.1693154, PDF,    科研立项经费支持
作者: 宋仕琪：河北工程大学医学院，河北 邯郸
关键词: 糖尿病足溃疡；外泌体；间充质干细胞；创面愈合；血管生成 ；Diabetic Foot Ulcers； Exosomes； Mesenchymal Stem Cells； Wound Healing； Angiogenesis
摘要: 目的：外泌体作为细胞间通讯的关键介质，在糖尿病足溃疡(Diabetic Foot Ulcer, DFU)修复中展现出独特的治疗潜力。本文旨在系统综述外泌体促进DFU修复的作用机制、不同细胞来源的治疗效应及临床转化进展。方法：检索PubMed、Web of Science等数据库中关于外泌体治疗DFU的相关文献，从DFU的病理生理特征、外泌体的生物学功能、不同来源外泌体的治疗效应及工程化策略等角度进行归纳分析。结果：外泌体可通过促进血管生成、调控巨噬细胞M1向M2表型极化、抑制炎症反应、恢复成纤维细胞功能等多重机制加速DFU创面愈合。间充质干细胞(Mesenchymal Stem Cell, MSC)、脂肪干细胞(Adipose-Derived Stem Cell, ADSC)、富血小板血浆(Platelet-Rich Plasma, PRP)等不同来源的外泌体在动物实验及临床试验中均展现出促进创面愈合的效果。水凝胶等生物材料负载外泌体可显著提高其在创面的滞留时间和生物利用度。早期临床试验已初步证实外泌体治疗DFU的安全性和有效性。结论：外泌体疗法为DFU修复提供了一种有前景的无细胞再生策略，但标准化生产、质量控制及大规模随机对照临床试验仍是其临床转化的主要瓶颈。
Abstract: Objective: As key mediators of intercellular communication, exosomes have demonstrated unique therapeutic potential in the healing of diabetic foot ulcers (DFUs). This article aims to provide a systematic review of the mechanisms by which exosomes promote DFU healing, the therapeutic effects of exosomes derived from different cell sources, and progress in clinical translation. Methods: We searched databases such as PubMed and Web of Science, and other databases for relevant literature on exosome therapy for DFUs, and conducted a systematic analysis from the perspectives of the pathophysiological characteristics of DFUs, the biological functions of exosomes, the therapeutic effects of exosomes from different sources, and engineering strategies. Results: Exosomes can accelerate DFU wound healing through multiple mechanisms, including promoting angiogenesis, regulating the phenotypic polarization of macrophages from M1 to M2, suppressing inflammatory responses, and restoring fibroblast function. Exosomes derived from various sources—including mesenchymal stem cells (MSCs), adipose-derived stem cells (ADSCs), and platelet-rich plasma (PRP)—have demonstrated wound-healing effects in both animal studies and clinical trials. Loading exosomes onto biomaterials such as hydrogels can significantly increase their retention time and bioavailability at the wound site. Early clinical trials have preliminarily confirmed the safety and efficacy of exosome therapy for DFUs. Conclusion: Exosome therapy offers a promising cell-free regenerative strategy for DFU repair; however, standardized production, quality control, and large-scale randomized controlled clinical trials remain the primary bottlenecks for its clinical translation.
文章引用：宋仕琪. 外泌体在糖尿病足溃疡修复中的研究进展[J]. 临床医学进展, 2026, 16(9): 1194-1204. https://doi.org/10.12677/acm.2026.1693154

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