曹宸 严志新 杨细虎

[摘要]慢性难愈性创面是临床创面修复的一大难题，目前治疗措施包括手术治疗和非手术治疗，但其效果均存在不确定性，愈后极易复发，少数有癌变可能。目前临床上应用的间充质干细胞（MSCs）是一种具有多分化潜能的基质细胞，但其应用前景具有一定局限性。而间充质干细胞外泌体（MSCs-Exo）是一种在特定条件下被细胞释放的小直径细胞外囊泡，是一种具有极大前景的无细胞治疗和组织再生的调控介质。相比间充质干细胞具有更低的免疫源性及低致癌性。研究表明，间充质干细胞外泌体的应用为慢性创面的治疗提供了一种新的思路和方法，本研究对间充质干细胞外泌体应用于慢性创面治疗的研究进展进行综述。

[关键词]间充质干细胞;外泌体;慢性创面;创口愈合

[中图分类号] R641  [文献标识码] A   [文章编号]2095-0616（2021）23-0044-04

Research progress of the application of mesenchymal stem cells- exosomes on chronic wounds

CAO  Chen      YAN  Zhixin    YANG  Xihu

1. Jiangsu University， Jiangsu， Zhenjiang 212013， China;2. Affiliated Hospital of Jiangsu University， Jiangsu， Zhenjiang 212013， China

[Abstract] Chronic refractory wound is a difficult problem in clinical wound repair. At present， the treatment measures include surgical treatment and non-surgical treatment， but there are all certain uncertainties in its efficacy. Meanwhile， it is very easy to relapse after healing， and a few may possibly become cancerous. At present， mesenchymal stem cells （MSCs） in clinical application are a kind of stromal cells with multi differentiation potential， but their application prospect has some restrictions. However， mesenchymal stem cells-exosomes （MSCs-Exo） are small-diameter extracellular vesicles released by cells under specific conditions. It is a regulatory medium for cell- free therapy and tissue regeneration with great prospects. Compared with mesenchymal stem cells， MSCs-Exo have features such as lower immunogenicity and low carcinogenicity. Research shows that the application of MSCs-Exo provides a new idea and method for the treatment of chronic wounds. The research progress of MSCs-Exo in the treatment of chronic wounds is reviewed in this paper.

[Key words] Mesenchymal stem cell; Exosomes; Chronic wound; Wound healing

慢性難愈性创面，是创面因组织营养不良、神经损伤、静脉或动脉供血障碍、创面感染、糖尿病等因素，导致创面修复能力受损，愈合缓慢甚至不愈合而形成的疾病[1]，是外科常见病、多发病[2]。此类创面长期不愈，反复破溃后形成顽固性难愈性慢性创面，即使愈合也极易复发，甚至有可能癌变[3]。因此，促进慢性创面愈合是临床治疗的一项世界性难题。慢性创面的愈合和皮肤再生是一个复杂的过程，包括止血、消炎、增殖和重塑四个阶段。临床上常用的扩创术、自体皮移植术、多种敷料和创面覆盖物保护创面以及抗感染等是创面治疗的一般方法，目的是加速创面的自然愈合[4]。……