The therapeutic, diagnostic, and prognostic values of extracellular vesicles (exosomes) in dermatology: A systematic review

This is the authors' abstract. We don't add key points for this paper.

The clinical exploration of extracellular vesicles (EVs, also called exosomes) in dermatology has recently grown, including cosmeceuticals.This systematic review aimed to collate existing clinical observations on EVs in dermatology for either therapeutic intervention or as a diagnostic or prognostic tool and to critically assess the degree of evidence of any observed feature.Primary studies that enrolled patients with dermatologic conditions and reported any role of EVs were included.Screening analysis, data extraction, and quality assessment were performed by 4 investigators.GRADE-CERQual, an adapted approach for the assessing the certainty of evidence qualitative sytematic reviews, was utilized to determine certainty and confidence for qualitative data.Outcomes included the therapeutic effectiveness of EVs' formulations, their safety, and any diagnostic potential.Fifty-two studies reporting data from 3066 patients were included.Methodologic inconsistencies, poor reporting, and low numbers of patients enrolled reduced the degree of certainty.The potential diagnostic and prognostic utilization of EVs were studied but have not been validated.EVs are being introduced into dermatology practices globally as cosmeceuticals.Observational studies have implied some therapeutic efficacy, but from a regulatory perspective, to our knowledge, no EV-based therapeutics has been approved in dermatology.Future clinical trials need to be randomized, double-blind, and placebo-controlled to support regulatory approvals, as diagnostic findings need to be supported by larger clinical cohorts.( JAAD Reviews 2024;1:135-74.)