Mesenchymal Stem Cell-Derived Extracellular Vesicles and Plant-Derived Nanovesicles as Cell-Free Therapies for Thermal Burn Healing: A Systematic Review of Preclinical Evidence and Delivery Strategies

This systematic review evaluates 50 preclinical studies on the use of mesenchymal stem cell-derived extracellular vesicles (EVs) and plant-derived nanovesicles (PDNVs) for thermal burn healing. The review finds that these vesicles significantly enhance wound healing by promoting angiogenesis, reducing inflammation, and accelerating wound closure. Mammalian MSC-derived vesicles, particularly from adipose-derived stem cells, show strong anti-fibrotic effects, while human umbilical cord MSC vesicles reduce systemic inflammation. Plant-derived nanovesicles exhibit significant antioxidant and re-epithelialization effects. Advanced delivery systems, such as bioactive hydrogels and microneedle patches, improve therapeutic retention and durability. The findings suggest that vesicle-based therapies are promising, scalable, and low-risk alternatives to live cell transplantation, although further research is needed to optimize delivery strategies and confirm efficacy in clinical settings.