Facial Reconstruction Surgery Enhanced by

WJ-MSC Exosomes Therapy

in a Deep facial cut Injury

History

Treatment

A 1 years old German shepherd dog presented for two deep cut wounds caused by

a knife attack from a lunatic at the street while on a walk

the case treated with WJ-MSC Exosomes as following

WARTONJELLY MESENCHYMAL STEM CELL DERIVED EXOSOMES

WJ-MSC exosomes are tiny nanosized vesicles (30–150 nanometers in diameter) that are released by Wharton’s Jelly Mesenchymal Stem Cells — which come from the Wharton’s jelly of the umbilical cord (the soft connective tissue surrounding the umbilical vessels)a


Source:
WJ-MSCs are derived from the Wharton’s jelly of the umbilical cord, a rich and ethically accessible source of stem cells.

Characteristics:

  • Multipotent — can differentiate into fibroblasts, endothelial cells, adipocytes, osteocytes, and others.
  • Exhibit anti-inflammatory, immunomodulatory, and tissue-repairing properties.
  • Low immunogenicity — can be used allogenically (from donor to recipient) without rejection



Stimulate fibroblast proliferation and collagen type III synthesis (early healing matrix).


Promote angiogenesis (formation of new blood vessels).


Suppress inflammation and oxidative stress.


Inhibit myofibroblast overactivation, which is responsible for scar tissue and contracture formation.


Clinical Benefits in Surgeries:


Accelerated Wound Healing:

Exosomes boost regeneration of skin, muscle, and connective tissue, leading to faster closure and recovery.


Reduced Inflammation and Infection Risk:

Their immunomodulatory effects minimize local inflammation and secondary infection.


Scar-Free Healing:

By collagen remodeling and reducing fibrotic signaling

WJ-MSC exosomes promote regeneration rather than repair, resulting in smoother, more natural skin texture.


Improved Skin Quality and Pigmentation:

Encourages normal melanocyte function and organized dermal structure, leading to uniform color and elasticity.


Enhanced Integration of Surgical Repair:

In reconstructive procedures, exosomes help grafted or sutured tissues integrate seamlessly with surrounding skin.


Neuroprotective and Angiogenic Effects:

Support recovery of minor nerve and vascular injury often associated with deep facial cuts.

1. Immunomodulatory Effects Against Tumor Cells


WJ-MSCs have a remarkable ability to modulate the immune response, which can indirectly suppress tumor growth:


They enhance anti-tumor immunity by stimulating natural killer (NK) cells, cytotoxic T lymphocytes, and macrophages to attack abnormal cells.


They secrete immunoregulatory cytokines such as:


Interferon-γ (IFN-γ) and Tumor Necrosis Factor-α (TNF-α) – increase cytotoxic immune activity.


Interleukin-10 (IL-10) and TGF-β – regulate excessive inflammation but maintain immune surveillance.


WJ-MSCs can downregulate tumor-supportive inflammatory cytokines (IL-6, IL-8, and IL-1β), which are often involved in tumor proliferation and angiogenesis.


2. Induction of Tumor Cell Apoptosis


Several studies have shown that WJ-MSCs can induce apoptosis (programmed cell death) in certain tumor cells through multiple mechanisms:


Release of pro-apoptotic factors such as TRAIL (TNF-related apoptosis-inducing ligand) and caspase activators.


Cell-to-cell contact via gap junctions or exosomes can trigger apoptosis in neoplastic cells.


Modulation of mitochondrial pathways leading to apoptotic cell death.


This effect varies depending on tumor type more evident in epithelial or carcinoma-type cells, which include trichoblastiomas .


3. Inhibition of Tumor Cell Proliferation


WJ-MSCs can slow tumor progression through paracrine signaling that alters the local environment:


Secretion of growth-inhibitory molecules which block proliferative signaling pathways


Inhibition of angiogenesis in neoplastic tissue ( depriving the tumor of its blood supply )


exosomes containing microRNAs that downregulate oncogenic genes in tumor cells.


4. Remodeling of the Tumor Microenvironment (TME)


WJ-MSCs can transform a tumor-supportive microenvironment into a hostile environment for tumor survival:


Reduce oxidative stress and inflammatory mediators that promote mutagenic activity.


Recruit anti-tumor immune cells and limit infiltration of tumor-associated macrophages which typically protect tumors.


5. Anti-Angiogenic Effects


Tumor growth depends on new vessel formation (angiogenesis). WJ-MSCs can counter this by:


Secreting angiogenesis inhibitors


Downregulating VEGF and PDGF signaling in nearby endothelial cells.


Reducing the density of microvessels in the tumor bed, thus starving the tumor of oxygen and nutrients.


6. Exosome-Mediated Anti-Cancer Activity


WJ-MSC-derived exosomes play a central role in cell-to-cell communication and can deliver anti-oncogenic microRNAs and proteins directly to tumor cells:


These exosomes carry miRNAs that target oncogenes


They can block cell cycle progression, inhibit epithelial-mesenchymal transition (EMT), and reduce metastasis potential.


Their nano-size allows them to reach deep tumor tissues efficiently without immunologic rejection.


7. Selective Cytotoxicity and Safety


Unlike chemotherapeutic drugs, WJ-MSCs do not damage healthy cells. They exhibit selective inhibition of rapidly dividing or mutated cells while promoting repair of normal tissue.


This dual function anti-tumor + regenerative makes them ideal therapeutic option

Warton’s Jelly–derived Mesenchymal Stem Cell (WJ-MSC) exosomes are administered locally at the surgical as

  • Injected around wound margins and into the subdermal plane to stimulate cellular regeneration.
  • Topically applied as an exosome-rich hydrogel combined with platelet-rich plasma (PRP) to enhance absorption and local activity.
    Topical application repeated to sustain regenerative effects.
  • In this case it is used only in the facial site and not in the back due to its relatively high cost , also longer back hair can cover the scar over the back

facial cut

back cut

When presented to the clinic

.

Dirty scrub before the surgery : injury extending down to the skull

10 days post surgical ( note the difference in scar formation & tissue healing )

after 3 weeks after the surgery

complete recovery almost no scar tissue to be found

complete recovery almost no scar tissue to be found

Minor scar in the back covered with the hair with no visual injury to the sight

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