Journal of Nanotheranostics

Diabetic wounds remain chronically non-healing due to impaired angiogenesis, persistent inflammation, and defective extracellular matrix remodelling. In recent years, stem cell-derived exosomes have emerged as a potent cell-free regenerative strategy capable of recapitulating the therapeutic benefits of mesenchymal stem cells while avoiding risks associated with direct cell transplantation. This review critically evaluates the preclinical evidence supporting the use of exosomes derived from adipose tissue, bone marrow, umbilical cord, and induced pluripotent stem cells for diabetic wound repair. These exosomes deliver bioactive cargos such as microRNAs, proteins, lipids, and cytokines that modulate key signalling pathways, including Phosphatidylinositol 3-kinase/Protein kinase (PI3K/Akt), Nuclear factor kappa B (NF-κB), Mitogen-activated protein kinase (MAPK), Transforming growth factor-beta (TGF-β/Smad), and Hypoxia inducible factor-1α/Vascular endothelial growth factor (HIF-1α/VEGF), thereby promoting angiogenesis, accelerating fibroblast and keratinocyte proliferation, facilitating re-epithelialization, and restoring immune balance through M2 macrophage polarization. A central focus of this review is the recent advances in exosome-based delivery systems, including hydrogels, microneedles, 3D scaffolds, and decellularized extracellular matrix composites, which significantly enhance exosome stability, retention, and targeted release at wound sites. Comparative insights between stem cell therapy and exosome therapy highlight the superior safety, scalability, and regulatory advantages of exosome-based approaches. We also summarize progress in exosome engineering, manufacturing, quality control, and ongoing clinical investigations, along with challenges related to standardization, dosage, and translational readiness. Collectively, this review provides a comprehensive mechanistic and translational framework that positions stem cell-derived exosomes as a next-generation, cell-free regenerative strategy with the potential to overcome current therapeutic limitations and redefine clinical management of diabetic wound healing.

Cancer remains a severe global health threat, with traditional therapies often plagued by limited efficacy and significant side effects. The emergence of nanotechnology, particularly metal-doped nanomaterials, offers a promising avenue for integrating diagnostic and therapeutic functions into a single platform, enabling a theranostic approach to oncology. This article explores the design and application of various metal-doped nanosystems, including gadolinium-doped selenium molybdenum nanosheets for magnetic resonance/photoacoustic dual-mode imaging and photothermal therapy, and metal-doped hollow mesoporous silica nanoparticles that leverage the tumor’s acidic microenvironment to release ions for catalytic generation of reactive oxygen species. Despite their promise, the limited enzyme-like activity of some nanozymes, insufficient endogenous hydrogen peroxide in tumors, and the tumor microenvironment’s defensive mechanisms, such as high glutathione levels, can restrict therapeutic efficacy. Looking forward, the outlook for the field is contingent upon advancing material engineering strategies. Future research should prioritize the development of intelligent, multifunctional nanoplatforms that can dynamically respond to and remodel the tumor microenvironment. Innovations in surface modification for enhanced targeting, alongside rigorous preclinical studies focused on safety and standardized manufacturing, are crucial for bridging the gap between laboratory research and clinical application, ultimately paving the way for personalized cancer medicine.

Obesity and type 2 diabetes are closely linked and often referred to as diabesity. Therapies of diabesity include improving intestinal health and reducing intake of fat and sugars. Diagnosis of diabesity-related metabolic disorders would involve monitoring of glucose and other factors. Nanocellulose, also known as cellulose nanomaterials, is emerging as a potential material for various applications. It has unique properties, such as high surface area, biodegradable, biocompatibility and tunable surface chemistry. In this review, we initially provided a brief description of differently produced nanocellulose and their potential applications in different areas, including therapeutics and diagnostics, by focusing on obesity and diabetes. Then, the uptake, absorption, distribution, metabolism and excretion of nanocellulose were discussed. Further, the mechanisms of nanocellulose in modulating diabesity were summarized by emphasizing the role of gut microbiota. Finally, we discussed gut microbiota-related health effects of nanocellulose, both beneficial and detrimental. It was found that the interactions between nanocellulose and gut were complex, with alterations of microbial composition, metabolic activity, and the immune functions both locally and systemically. There seemed to be many beneficial changes following short-term exposure to nanocellulose (e.g., increased beneficial bacteria and decreased pathogenic ones); however, some of these effects were no longer seen after long-term consumption. Importantly, long-term nanocellulose consumption may be associated with certain detrimental health effects, e.g., malnutrition and its associated neurotoxicity, although additional studies are needed to substantiate such health implications. This information is critical for developing safe and effective nanocellulose derivatives that can be applied in food and medicine as well as to harness the benefits of the gut microbiota.