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Here, we developed an exosome\u2010integrated hydrogel system based on citrate\u2010crosslinked hydroxypropyltrimethyl ammonium chloride chitosan (HACC), incorporating exosomes derived from stem cells of the apical papilla (SCAP\u2010Exo) to modulate immune responses and promote diabetic wound repair. The SCAP\u2010Exo\u2013loaded HACC hydrogel exhibited favorable physicochemical properties and enabled sustained local exosome release. In vitro studies demonstrated efficient uptake of SCAP\u2010Exo by macrophages, leading to a pronounced shift toward an anti\u2010inflammatory, pro\u2010reparative phenotype. MicroRNA profiling and functional validation identified miR\u2010122\u20105p as a key bioactive component enriched in SCAP\u2010Exo, mediating macrophage reprogramming through the regulation of inflammatory signaling and metabolism\u2010associated pathways. Consequently, the remodeled immune microenvironment enhanced fibroblast proliferation and migration. In a diabetic wound model, treatment with the SCAP\u2010Exo\u2013functionalized HACC hydrogel significantly accelerated wound closure, improved granulation tissue formation, and promoted collagen deposition. Collectively, this study demonstrates that SCAP\u2010Exo\u2013based HACC hydrogel therapy facilitates diabetic wound healing through miRNA\u2010driven immunometabolic modulation, highlighting a promising strategy for the treatment of chronic wounds.<\/jats:p>","DOI":"10.1002\/adhm.71338","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:24:49Z","timestamp":1780979089000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["SCAP\u2010Exo\u2010Integrated CA\/HACC Hydrogel Promotes Diabetic Wound Repair via miR\u2010122\u2010Driven Macrophage Phenotypic Transition"],"prefix":"10.1002","volume":"15","author":[{"given":"Xuan","family":"Jing","sequence":"first","affiliation":[{"name":"Shanxi Medical University School and Hospital of Stomatology  Taiyuan Shanxi China"},{"name":"Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials  Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanxi Medical University School and Hospital of Stomatology  Taiyuan Shanxi China"},{"name":"Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials  Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyang","family":"Bai","sequence":"additional","affiliation":[{"name":"Shanxi Medical University School and Hospital of Stomatology  Taiyuan Shanxi China"},{"name":"Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials  Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijun","family":"Du","sequence":"additional","affiliation":[{"name":"Shanxi Medical University School and Hospital of Stomatology  Taiyuan Shanxi China"},{"name":"Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials  Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Hu","sequence":"additional","affiliation":[{"name":"Shanxi Medical University School and Hospital of Stomatology  Taiyuan Shanxi China"},{"name":"Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials  Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudong","family":"Guo","sequence":"additional","affiliation":[{"name":"Shanxi Medical University School and Hospital of Stomatology  Taiyuan Shanxi China"},{"name":"Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials  Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojie","family":"Lian","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Research Center for Nano\u2010biomaterials &amp; Regenerative Medicine, Shanxi Key Laboratory of Functional Proteins, College of Artificial Intelligence Taiyuan University of Technology  Taiyuan P. 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