International Journal of Molecular Medical Science, 2025, Vol.15, No.5, 214-223 http://medscipublisher.com/index.php/ijmms 219 Figure 2 Schematic diagram of chiral hydrogel preparation and promoted wound healing by applying the dextral chiral hydrogel with right-handed nanofibers aswounddressing.a)Schematicillustrating the synthetic route of the supramolecular chiral hydrogel. b) Schematic illustrating the molecular signaling that mediates the dextral chiral hydrogel-induced keratinocyte proliferation and migration (Adopted from Zhu et al., 2021) In addition, these dressings can also achieve the staged release of multiple growth factors: first inhibit inflammation (such as through IL-10), then promote angiogenesis (such as through VEGF and PDGF), improve the local environment, and accelerate repair (Kuan et al., 2024). This multi-signal interaction can simultaneously promote vascularization, collagen deposition, granulation growth and overall regeneration (Shang et al., 2024). 5.3 The role of exosomes, small RNAs and intercellular communication in repair More and more studies have shown that exosomes and micrornas (mirnas) play an important role in wound repair through intercellular communication. Regenerative dressings capable of releasing or delivering exosomes, especially those derived from mesenchymal stem cells or adipose tissue, can promote the growth, migration and collagen synthesis of fibroblasts and endothelial cells (Shang et al., 2024). These exosomes contain multiple active molecules, including miRNA, which can regulate gene expression related to cell proliferation, angiogenesis and ECM remodeling, thereby accelerating tissue regeneration. Hydrogels or scaffolds with exosomes added can activate signaling pathways such as PTEN/AKT/VEGF and HIF-1α/VEGFA, thereby effectively promoting angiogenesis and tissue repair. This effect is particularly prominent in chronic wounds and diabetic wounds. The combined use of exosomes, mirnas and growth factors in smart dressings can achieve more effective and longer-lasting wound healing effects by adjusting the information transmission between cells (Lee et al., 2023).
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