Abstract
Peripheral neuropathy and poor blood circulation caused by long-term hyperglycemia in patients with diabetes often leads to foot wounds, ulcers, and gangrene, which accompanied by an imbalance in the wound immune microenvironment. Extracellular vesicle (EV) therapy is an emerging biologic treatment method. EV possesses advantages such as good biocompatibility, high efficacy, low immunogenicity, and low tissue toxicity. By modulating the immune responses and cellular functions in the microenvironment, EV can reduce inflammation levels in wounds, showing great potential in accelerating diabetic wound healing. This review summarizes the mechanism by which EV participates in regulating wound healing through the modulation of various inflammatory and non-inflammatory cells in the microenvironment of diabetic wounds, discusses the advantages and limitations of various approaches of the clinical translation of EV, proposes the concept of combining EV therapy with the disease microenvironment, thereby providing new insights for further researches on the clinical application of EV.