{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:24:46Z","timestamp":1790691886215,"version":"4.1.0"},"reference-count":109,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertrophic scars and keloids, types of pathological scars, arise from dysregulated wound healing, marked by abnormal fibroblast activation and excessive extracellular matrix (ECM) deposition. Current treatments have high recurrence rates and side effects, necessitating targeted therapies. Exosomes, extracellular vesicles mediating intercellular communication, offer multi\u2010target regulatory potential to address scar formation complexities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This narrative review synthesizes in\u00a0vitro and in\u00a0vivo studies (2020\u20132025) from PubMed and Scopus on exosomes' role in regulating hypertrophic scars and keloids, proposing innovative therapeutic approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Therapeutic exosomes attenuate inflammation, promote wound healing, inhibit fibrosis, and modulate the scar microenvironment. They suppress fibroblast\u2010to\u2010myofibroblast transformation, regulate collagen synthesis, and inhibit fibrotic pathways, particularly via the Transforming Growth Factor\u2010beta\/Sma\u2010 and Mad\u2010related protein (TGF\u2010\u03b2\/Smad) signaling pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exosomes are a promising cell\u2010free therapy for pathological scars due to their multi\u2010target regulatory capabilities. Future research should optimize large\u2010scale production, standardize protocols, and develop targeted delivery systems to enable clinical translation, with validation through clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.70705","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T09:20:19Z","timestamp":1769764819000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exosomes in Hypertrophic Scars and Keloids: Mechanisms and Therapeutic Potentials\u2014A Narrative Review"],"prefix":"10.1111","volume":"25","author":[{"given":"Mengke","family":"Wu","sequence":"first","affiliation":[{"name":"Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine  Nanjing China"},{"name":"Nanjing University of Chinese Medicine  Nanjing 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Yong","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine  Nanjing China"},{"name":"Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaxu","family":"Liu","sequence":"additional","affiliation":[{"name":"Hospital for Skin Diseases, Shandong First Medical University  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9291-7451","authenticated-orcid":false,"given":"Qin","family":"Guo","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine  Nanjing 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