Fengyu Wang,1,2,* Jinling Yao,3,* Huiling Zuo,1,2 Yuhang Jiao,1,2 Junzi Wu,1,2 Zhuoran Meng1,2 

1The Key Laboratory of Microcosmic Syndrome Differentiation, Yunnan University of Chinese Medicine, Kunming, Yunnan, 650500, People’s Republic of China; 2Yunnan Key Laboratory of Integrated Traditional Chinese and Western Medicine for Chronic Disease in Prevention and Treatment, Yunnan University of Chinese Medicine, Kunming, Yunnan, 650500, People’s Republic of China; 3Yunnan Province Dai and Yi Medicine Primary Laboratory, Yunnan University of Chinese Medicine, Kunming, Yunnan, 650500, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Junzi Wu, The Key Laboratory of Microcosmic Syndrome Differentiation, Yunnan University of Chinese Medicine, Kunming, People’s Republic of China, Email xnfz@ynucm.edu.cn Zhuoran Meng, The Key Laboratory of Microcosmic Syndrome Differentiation, Yunnan University of Chinese Medicine, Kunming, People’s Republic of China, Email ynmengzhuoran@163.com

Abstract: Diabetic wounds represent a pressing clinical challenge in the medical field. Compared to healthy individuals, patients with diabetes present with various complications, including abnormal blood sugar levels, microcirculation disorders, and impaired cellular function. Moreover, they are at a higher risk for skin damage and have a more difficult healing process. In recent years, exosome-based regenerative medicine has provided new strategies for diabetic wound treatment. The bioactive molecules contained in the exosomes, including functional proteins, bioactive lipids, and regulatory RNAs, allow them to suppress inflammation, enhance cell migration, and promote angiogenesis. As exosomes from different sources have different composition and function, the characteristics of their source must be considered when using them. Unlike traditional single source research, this review describes the mechanism of action of exosomes from different sources in diabetic wound-healing process, including mammalian cell-derived exosomes and plant-derived exosome-like nanoparticles. These findings not only provide a theoretical basis for the selection of exosome sources but also lay a foundation for the development of personalized, multimodal treatment plans.

Keywords: exosomes, diabetic wounds healing, mammalian-derived exosomes, plant-derived exosome-like nanoparticles, drug delivery, nanomedicine