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Exosomes derived from umbilical cord mesenchymal stem cells (UC-MSCs) are nanoscale extracellular vesicles (30–200 nm) secreted by these multipotent stromal cells. These exosomes contain proteins, lipids, DNA, and RNA reflective of their parent MSCs and mediate many of the therapeutic effects attributed to MSC therapy. They have demonstrated regenerative, immunomodulatory, anti-inflammatory, proangiogenic, and neuroprotective properties in preclinical models and early clinical trials. Mechanistically, they promote tissue repair by modulating immune responses (e.g., inducing M2 macrophage polarization), enhancing angiogenesis via upregulation of VEGF and TGFβ-1 expression[1][3], stimulating fibroblast proliferation[8], promoting collagen synthesis[1][2], reducing inflammation through downregulation of IL-1β and TNF-α[3], supporting nerve regeneration in wound healing[8], and protecting cartilage in osteoarthritis models[3]. Unlike cell-based therapies with live MSCs, exosome-based approaches offer advantages such as lower risk of immune rejection or ectopic tissue formation and greater stability for storage/transportation. Clinical studies have explored their use for chronic wounds[1][5][8], spinal cord injury (SCI)[6], post-COVID chronic cough[7], melasma/skin regeneration[9] among others.
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