Review Article | | Peer-Reviewed

Application of Polysaccharide Hydrogel Loaded Mesenchymal Stem Cell Exosomes in Diabetic Wound Repair Research Progress

Received: 18 September 2025     Accepted: 29 September 2025     Published: 29 October 2025
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Abstract

The impaired healing of diabetic wounds is a key factor leading to foot ulcers, wound gangrene, and even amputations in patients. Mesenchymal stem cell exosomes offer a novel therapeutic strategy for diabetic wound repair; however, exosomes are easily cleared by the immune system in vivo and have a short retention time in tissues, resulting in suboptimal therapeutic efficacy. Polysaccharide-based hydrogels are ideal delivery carriers for exosomes. This article analyzes the causes of difficult diabetic wound healing, provides a brief overview of the applications of mesenchymal stem cell-derived exosomes and polysaccharide-based hydrogels in diabetic wound healing, and discusses the role of polysaccharide-based hydrogels loaded with exosomes in promoting diabetic wound healing. This work aims to provide a reference for the application of exosome-loaded polysaccharide-based hydrogels in diabetic wound repair.

Published in International Journal of Diabetes and Endocrinology (Volume 10, Issue 4)
DOI 10.11648/j.ijde.20251004.11
Page(s) 78-84
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Mesenchymal Stem Cells, Exosomes, Polysaccharide Hydrogel, Diabetes, Wound Repair

References
[1] Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes research and clinical practice, 2022, 183: 109119.
[2] Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes, 2015, 6(6): 850-867.
[3] Dawi J, Tumanyan K, Tomas K, et al. Diabetic Foot Ulcers: Pathophysiology, Immune Dysregulation, and Emerging Therapeutic Strategies. Biomedicines, 2025, 13(5): 1076.
[4] Zhang J, Liu H, Che T, et al. Nanomaterials for diabetic wound healing: Visualization and bibliometric analysis from 2011 to 2021. Frontiers in Endocrinology, 2023, 14: 1124027.
[5] McDermott K, Fang M, Boulton A J M, et al. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes care, 2023, 46(1): 209-221.
[6] Bekele F, Chelkeba L. Amputation rate of diabetic foot ulcer and associated factors in diabetes mellitus patients admitted to Nekemte referral hospital, western Ethiopia: prospective observational study. Journal of foot and ankle research, 2020, 13(1): 65.
[7] Jin KM, Lu J. Research progress in the treatment of diabetes by mesenchymal stem cells. Academic Journal of Naval Medical University, 2025, 46(5): 644-652.
[8] Zhou J, Wei T, He Z. ADSCs enhance VEGFR3-mediated lymphangiogenesis via METTL3-mediated VEGF-C m6A modification to improve wound healing of diabetic foot ulcers. Molecular Medicine, 2021, 27(1): 146.
[9] Yi WJ, Yuan Y, Bao Q, et al. Analyzing immune cell infiltration and copper metabolism in diabetic foot ulcers. Journal of Inflammation Research, 2024: 3143-3157.
[10] Khazaei F, Rezakhani L, Alizadeh M, et al. Exosomes and exosome-loaded scaffolds: characterization and application in modern regenerative medicine. Tissue and Cell, 2023, 80: 102007.
[11] Zhu D, Hu Y, Kong X, et al. Enhanced burn wound healing by controlled-release 3D ADMSC-derived exosome-loaded hyaluronan hydrogel. Regenerative Biomaterials, 2024, 11: rbae035.
[12] Yuan N, Shao K, Huang S, et al. Chitosan, alginate, hyaluronic acidand other novel multifunctional hydrogel dressings for wound healing: A review. Int J Biol Macromol, 2023, 240: 124321.
[13] Wang D, Yang X, Liu Q, et al. Enzymatically cross-linked hydrogelsbased on a linear poly(ethylene glycol) analogue for controlled proteinrelease and 3D cell culture. J Mater Chem B, 2018, 6(38): 6067-6079.
[14] Xu Y, Hu Q, Wei Z, et al. Advanced polymer hydrogels that promote diabetic ulcer healing: mechanisms, classifications, and medical applications. Biomaterials research, 2023, 27(1): 36.
[15] Fu-Shin XY, Lee PSY, Yang L, et al. The impact of sensory neuropathy and inflammation on epithelial wound healing in diabetic corneas. Progress in Retinal and Eye Research, 2022, 89: 101039.
[16] Kaushik K, Das A. TWIST1-reprogrammed endothelial cell transplantation potentiates neovascularization-mediated diabetic wound tissue regeneration. Diabetes, 2020, 69(6): 1232-1247.
[17] Guo W, Qiu W, AO X, et al. Low-concentration DMSO accelerates skin wound healing by Akt/mTOR-mediated cell proliferation and migration in diabetic mice. Br J Pharmacol, 2020, 177(14): 3327- 3341.
[18] Song J, Wu Y, Chen Y, et al. Epigenetic regulatory mechanism of macrophage polarization in diabetic wound healing. Molecular Medicine Reports, 2025, 31(1): 1-20.
[19] Wang H, Xu Z, Zhao M, et al. Advances of hydrogel dressings in diabetic wounds. Biomaterials science, 2021, 9(5): 1530-1546.
[20] Zhou Y, Huang H, Chen G, et al. Promoting the healing of diabetic wounds with an antimicrobial gel containing AgNPs with anti-infective and anti-inflammatory properties. Journal of Biomaterials science, Polymer edition, 2024, 35(8): 1236-1257.
[21] Liu Y, Liu Y, Deng J, et al. Fibroblast growth factor in diabeticfoot ulcer: progress and therapeutic prospects. Front Endocrinol(Lausanne), 2021, 12: 744868.
[22] Chakroborty D, Goswami S, Basu S, et al. Catecholamines in the regulation of angiogenesis in cutaneous wound healing. The FASEB Journal, 2020, 34(11): 14093-14102.
[23] He R, Li C, Wang RY, et al. Application of MXene-based hydrogels in the field of wound repair. Chinese Journal of Tissue Engineering Research, 2025, 29(16): 3486-3493.
[24] Päth G, Perakakis N, Mantzoros C S, et al. Stem cells in the treatment of diabetes mellitus—Focus on mesenchymal stem cells. Metabolism, 2019, 90: 1-15.
[25] Tong YY, Jin WY, Yang GH. Application of hydrogel-loaded stem cell exosomes in the field of tissueregeneration. Chinese Journal of Biotechnology, 2023, 39(4): 1351-1362.
[26] Shin KO, Ha D H, Kim JO, et al. Exosomes from human adipose tissue-derived mesenchymal stem cells promote epidermal barrier repair by inducing de novo synthesis of ceramides in atopic dermatitis. Cells, 2020, 9(3): 680.
[27] Kim H, Lee JW, Han G, et al. Extracellular vesicles as potential theranostic platforms for skin diseases and aging. Pharmaceutics, 2021, 13(5): 760.
[28] Bulati M, Gallo A, Zito G, et al. 3D culture and interferon-γ Priming modulates characteristics of mesenchymal stromal/stem cells by modifying the expression of both intracellular and exosomal microRNAs [J]. Biology, 2023, 12(8): 1063.
[29] Tu Y, Zheng W, Ding Z, et al. Exosome-loaded tannic acid–thioctic acid hydrogel enhances wound healing in coagulation disorders. Materials Today Bio, 2025, 31: 101496.
[30] Wu J, Yang Q, Wu S, et al. Adipose-derived stem cell exosomes promoted hair regeneration. Tissue Engineering and Regenerative Medicine, 2021, 18(4): 685-691.
[31] Wang HY, Ba T, Zhou B, et al. Effects of applying human umbilical cord mesenchymal stem cell exosomes throughh different pathways to treat full-thickness skin defect wounds in mice. Chin J Burns Wounds, 2024, 40(4): 314-322.
[32] Liang Y, He J, Guo B. Functional hydrogels as wound dressing to enhance wound healing. ACS nano, 2021, 15(8): 12687-12722.
[33] Tu Y, Chen N, Li C, et al. Advances in injectable self-healing biomedical hydrogels. ActaBiomater, 2019, 90: 1-20.
[34] Lai WF. Development of Hydrogels with Self-Healing Properties for Delivery of BioactiveAgents. Mol Pharm, 2021, 18(5): 1833-1841.
[35] Ren Y, Aierken A, Zhao L, et al. hUC-MSCs lyophilized powder loaded polysaccharide ulvandriven functional hydrogel for chronic diabetic wound healing. Carbohydr Polym, 2022, 288: 119404.
[36] Ren P, Zhang H, Dai Z, et al. Stiff micelle-crosslinked hyaluronate hydrogels with low swelling for potential cartilage repair. Journal of Materials Chemistry B, 2019, 7(36): 5490-5501.
[37] Graça MFP, Miguel SP, Cabral CSD, et al. Hyaluronic acid-Based wound dressings: A review. Carbohydr Polym, 2020, 241: 116364.
[38] Lynch CR, Kondiah PPD, Choonara YE. Advanced strategies for tissue engineering in regenerative medicine: A biofabrication and biopolymer perspective [J]. Molecules, 2021, 26(9): 2518.
[39] Gao D, Zhang Y, Bowers DT, et al. Functional hydrogels for diabetic wound management. APL Bioeng, 2021, 5(3): 31503.
[40] Cascone S, Lamberti G. Hydrogel-based commercial products for biomedical applications: A review. International journal of pharmaceutics, 2020, 573: 118803.
[41] Lan YL, Qi XL, Shen JL. Application of polysaccharide hydrogels in the treatment of diabetic wounds. Journal of Wenzhou University (Natural Science Edition), 2025, 46(3): 50-63.
[42] Alven S, Aderibigbe BA. Chitosan and cellulose-based hydrogels for wound management. International journal of molecular sciences, 2020, 21(24): 9656.
[43] Wang J, Zhuang S. Chitosan-based materials: Preparation, modification and application. Journal of Cleaner Production, 2022, 355: 131825.
[44] Elshaarani T, Yu H, Wang L, et al. Chitosan reinforced hydrogels with swelling-shrinkingbehaviors in response to glucose concentration. Int J Biol Macromol, 2020, 161: 109-121.
[45] Huang K, Liu W, Wei W, et al. Photothermal hydrogel encapsulating intelligently bacteria-capturing bio-MOF for infectious wound healing. Acs Nano, 2022, 16(11): 19491-19508.
[46] Lin Y, Xu J, Dong Y, et al. Drug-free and non-crosslinked chitosan/hyaluronic acid hybrid hydrogel for synergistic healing of infected diabetic wounds. Carbohydrate Polymers, 2023, 314: 120962.
[47] Qi X, Xiang Y, Cai E, et al. All-in-one: Harnessing multifunctional injectable natural hydrogels for ordered therapy of bacteria-infected diabetic wounds [J]. Chemical Engineering Journal, 2022, 439: 135691.
[48] Mittal A K, Bhardwaj R, Arora R, et al. Acceleration of wound healing in diabetic rats through poly dimethylaminoethyl acrylate–hyaluronic acid polymeric hydrogel impregnated with a Didymocarpus pedicellatus plant extract [J]. ACS omega, 2020, 5(38): 24239-24246.
[49] Yang H, Song L, Sun B, et al. Modulation of macrophages by a paeoniflorin-loaded hyaluronic acid-based hydrogel promotes diabetic wound healing. Materials Today Bio, 2021, 12: 100139.
[50] Xu Z, Liu G, Liu P, et al. Hyaluronic acid-based glucose-responsive antioxidant hydrogel platform for enhanced diabetic wound repair. Acta biomaterialia, 2022, 147: 147-157.
[51] Abka-Khajouei R, Tounsi L, Shahabi N, et al. Structures, properties and applications of alginates. Marine drugs, 2022, 20(6): 364.
[52] Zhang M, Zhao X. Alginate hydrogel dressings for advanced wound management. International Journal of Biological Macromolecules, 2020, 162: 1414-1428.
[53] Chi J, Li A, Zou M, et al. Novel dopamine-modified oxidized sodium alginate hydrogels promote angiogenesis and accelerate healing of chronic diabetic wounds. International journal of biological macromolecules, 2022, 203: 492-504.
[54] Safari B, Aghazadeh M, Davaran S, et al. Exosome-loaded hydrogels: A new cell-freetherapeutic approach for skin regeneration. Eur J Pharm Biopharm, 2022, 171: 50-59.
[55] Monguió-Tortajada M, Prat-Vidal C, Moron-Font M, et al. Local administration of porcine immunomodulatory, chemotactic and angiogenic extracellular vesicles using engineered cardiac scaffolds for myocardial infarction. Bioactive materials, 2021, 6(10): 3314-3327.
[56] Fan L, Liu C, Chen X, et al. Exosomes‐loaded Electroconductive hydrogel synergistically promotes tissue repair after spinal cord injury via Immunoregulation and enhancement of myelinated axon growth. Advanced Science, 2022, 9(13): 2105586.
[57] Hashemi A, Ezati M, Nasr M P, et al. Extracellular vesicles and hydrogels: an innovative approach to tissue regeneration. ACS omega, 2024, 9(6): 6184-6218.
[58] Zhang Y, Yan W, Wu L, et al. Different exosomes are loaded in hydrogels for the application in the field of tissue repair. Frontiers in Bioengineering and Biotechnology, 2025, 13: 1545636.
[59] Liu K, Gong B, Li T, et al. Bioactive self-healing umbilical cord blood exosomes hydrogelfor promoting chronic diabetic wound healing. Biochemical and Biophysical Research Communications, 2024, 690: 149241.
[60] Oprita EI, Iosageanu A, Craciunescu O. Natural polymeric hydrogels encapsulating small molecules for diabetic wound healing. Gels, 2023, 9(11): 867.
[61] Li M, Ke QF, Tao SC, et al. Fabrication of hydroxyapatite/chitosan composite hydrogels loaded with exosomes derived from miR-126-3p overexpressed synovial mesenchymal stem cells for diabetic chronic wound healing. Journal of Materials Chemistry B, 2016, 4(42): 6830-6841.
[62] Chen Y, Wang X, Tao S, et al. Research advances in smart responsive-hydrogel dressingswith potential clinical diabetic wound healing properties. Mil Med Res, 2023, 10(1): 37.
[63] Shi Q, Qian Z, Liu D, et al. GMSC-derived exosomes combined with a chitosan/silk hydrogel sponge accelerates wound healing in a diabetic rat skin defect model. Frontiers in physiology, 2017, 8: 904.
[64] Yang J, Chen Z, Pan D, et al. Umbilical cord-derived mesenchymal stem cell-derived exosomes combined pluronic F127 hydrogel promote chronic diabetic wound healing and complete skin regeneration. International journal of nanomedicine, 2020: 5911-5926.
[65] Yuan WY, Huang C, Deng WY, et al. Hyaluronic acid methacryloyl/chitosan methacryloyl/ 3-methacrylamidophenylboronic acid multifunctional hydrogel loading exosome for diabetic wound healing. International Journal of Biological Macromolecules, 2024, 280: 135562.
[66] Brennan MÁ, Layrolle P, Mooney DJ. Biomaterials functionalized with MSC secreted extracellular vesicles and soluble factors for tissue regeneration. Advanced functional materials, 2020, 30(37): 1909125.
Cite This Article
  • APA Style

    Xiao, D., Yan, Z., Longti, L. (2025). Application of Polysaccharide Hydrogel Loaded Mesenchymal Stem Cell Exosomes in Diabetic Wound Repair Research Progress. International Journal of Diabetes and Endocrinology, 10(4), 78-84. https://doi.org/10.11648/j.ijde.20251004.11

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    ACS Style

    Xiao, D.; Yan, Z.; Longti, L. Application of Polysaccharide Hydrogel Loaded Mesenchymal Stem Cell Exosomes in Diabetic Wound Repair Research Progress. Int. J. Diabetes Endocrinol. 2025, 10(4), 78-84. doi: 10.11648/j.ijde.20251004.11

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    AMA Style

    Xiao D, Yan Z, Longti L. Application of Polysaccharide Hydrogel Loaded Mesenchymal Stem Cell Exosomes in Diabetic Wound Repair Research Progress. Int J Diabetes Endocrinol. 2025;10(4):78-84. doi: 10.11648/j.ijde.20251004.11

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  • @article{10.11648/j.ijde.20251004.11,
      author = {Du Xiao and Zhan Yan and Li Longti},
      title = {Application of Polysaccharide Hydrogel Loaded Mesenchymal Stem Cell Exosomes in Diabetic Wound Repair Research Progress
    },
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {10},
      number = {4},
      pages = {78-84},
      doi = {10.11648/j.ijde.20251004.11},
      url = {https://doi.org/10.11648/j.ijde.20251004.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20251004.11},
      abstract = {The impaired healing of diabetic wounds is a key factor leading to foot ulcers, wound gangrene, and even amputations in patients. Mesenchymal stem cell exosomes offer a novel therapeutic strategy for diabetic wound repair; however, exosomes are easily cleared by the immune system in vivo and have a short retention time in tissues, resulting in suboptimal therapeutic efficacy. Polysaccharide-based hydrogels are ideal delivery carriers for exosomes. This article analyzes the causes of difficult diabetic wound healing, provides a brief overview of the applications of mesenchymal stem cell-derived exosomes and polysaccharide-based hydrogels in diabetic wound healing, and discusses the role of polysaccharide-based hydrogels loaded with exosomes in promoting diabetic wound healing. This work aims to provide a reference for the application of exosome-loaded polysaccharide-based hydrogels in diabetic wound repair.
    },
     year = {2025}
    }
    

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    T1  - Application of Polysaccharide Hydrogel Loaded Mesenchymal Stem Cell Exosomes in Diabetic Wound Repair Research Progress
    
    AU  - Du Xiao
    AU  - Zhan Yan
    AU  - Li Longti
    Y1  - 2025/10/29
    PY  - 2025
    N1  - https://doi.org/10.11648/j.ijde.20251004.11
    DO  - 10.11648/j.ijde.20251004.11
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
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    AB  - The impaired healing of diabetic wounds is a key factor leading to foot ulcers, wound gangrene, and even amputations in patients. Mesenchymal stem cell exosomes offer a novel therapeutic strategy for diabetic wound repair; however, exosomes are easily cleared by the immune system in vivo and have a short retention time in tissues, resulting in suboptimal therapeutic efficacy. Polysaccharide-based hydrogels are ideal delivery carriers for exosomes. This article analyzes the causes of difficult diabetic wound healing, provides a brief overview of the applications of mesenchymal stem cell-derived exosomes and polysaccharide-based hydrogels in diabetic wound healing, and discusses the role of polysaccharide-based hydrogels loaded with exosomes in promoting diabetic wound healing. This work aims to provide a reference for the application of exosome-loaded polysaccharide-based hydrogels in diabetic wound repair.
    
    VL  - 10
    IS  - 4
    ER  - 

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