Stem cell–derived secretome may offer an alternative to live cell therapies for chronic wound healing
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Key Takeaway
Consider stem cell–derived secretome as a potential alternative for chronic wound care, but recognize evidence is preliminary.
This is a narrative review examining the potential of stem cell–derived secretome as an alternative to live cell therapies for chronic wounds, including diabetic ulcers, venous leg ulcers, and pressure ulcers. The authors synthesize existing literature to argue that secretome may offer a safer, more practical option than live cell transplantation, though they do not report pooled effect sizes or comparative trial data. The review notes that direct evidence comparing secretome to live cell therapies is limited and that key outcomes such as efficacy and safety are not quantified in the available literature. Gaps include the lack of reported sample sizes, follow-up durations, and adverse event rates, which constrain definitive conclusions. The authors emphasize that secretome therapy remains an emerging approach, and its clinical role requires further validation through controlled studies. Practice relevance is not reported, and clinicians should interpret these findings as hypothesis-generating rather than practice-changing.
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View Original Abstract ↓
Chronic non-healing wounds, including diabetic ulcers, venous leg ulcers, and pressure ulcers, represent a significant clinical burden worldwide, associated with major economic costs and impaired quality of life. Although stem cell–based therapies have shown regenerative potential, recent accumulating evidence indicates that their therapeutic effects are primarily mediated by paracrine signaling rather than direct cell engraftment. Stem cell–derived secretome, which consists of soluble bioactive factors and extracellular vesicles, has gained attention as a promising cell-free strategy for wound healing. The secretome modulates inflammation, promotes angiogenesis, supports extracellular matrix remodeling, stabilizes redox homeostasis, and enhances cell survival, proliferation, and migration, thereby creating a pro-regenerative wound microenvironment. Secretome composition is very dynamic and influenced by the stem cell source, donor characteristics, and cell culture conditions, which impacts therapeutic efficacy. Compared with live cell therapies, secretome-based approaches offer improved safety, scalability, and storage potential while avoiding risks associated with cell transplantation. This review provides an overview of the biological processes involved in wound healing, discusses the main stem cell sources used in wound healing, and summarizes current knowledge on stem cell–derived secretome and its mechanisms of action. In addition, emerging delivery strategies, therapeutic advantages, and current challenges associated with secretome-based therapies are discussed, emphasizing their potential in wound regeneration.
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