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This combination therapy consists of a secretome derived from adipose-derived mesenchymal stem cells (ADMSCS) and exogenous transforming growth factor beta 3 (TGF-β3). Developed by Indonesia University and produced at Dr. Cipto Mangunkusumo Hospital, it is intended for the treatment of melasma. The secretome is a bioactive medium containing growth factors, cytokines, and extracellular vesicles (including exosomes) that promote tissue regeneration and depigmentation. TGF-β3 is specifically added to enhance the depigmenting effect by inhibiting melanogenesis through the downregulation of the ERK/MITF signaling pathway. This suppression of microphthalmia-associated transcription factor (MITF) leads to reduced tyrosinase activity and melanin accumulation. Unlike TGF-β1, TGF-β3 is reported to restore skin differentiation in UV-irradiated keratinocytes without the significant risk of inducing skin fibrosis.
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