Topical Cell-Free Therapy for Psoriasis: A Sponge-Based Secretome Formulation

In the field of regenerative dermatology, a 2025 study by Elgueta et al. published in Stem Cell Research & Therapy proposes a novel therapeutic solution to managing psoriasis vulgaris: using a freeze-dried sponge developed from the secretome of Wharton's Jelly-derived mesenchymal stem cells (hWJ-MSCs) and hyaluronic acid (HA). This investigational topical therapy delivers a cell-free, bioactive formulation designed for ease of use and storage stability, potentially circumventing many limitations of systemic stem cell treatments.

Addressing a Persistent Therapeutic Gap

Psoriasis affects up to 1.66 percent of the global population. Psoriasis vulgaris, the most common form of psoriasis, remains notoriously difficult to manage due to treatment-related side effects, high relapse rates, and poor adherence to treatment regimens. Mesenchymal stem cell therapy has emerged as a compelling candidate for immune modulation, yet systemic delivery poses challenges such as tumorigenicity and off-target biodistribution.

This study pivots from cell-based therapy to the use of the MSC secretome, which is a complex mix of cytokines, extracellular exosomes, and growth factors. To ensure molecular stability and enable topical self-application, researchers encapsulated the secretome in a lyophilized hyaluronic acid sponge.

Preclinical analyses confirmed the presence of spherical exosomes (164 ± 87 nm) with proangiogenic activity in vitro and in vivo, using both HUVEC tubule formation and chicken chorioallantoic membrane assays. Compared to plain HA sponges, the secretome-HA composite displayed a rougher, cross-linked morphology with slower dissolution rates in aqueous media, indicating potential for sustained topical delivery.

In a 30-day, randomized, double-blinded study involving 12 patients with bilateral psoriasis vulgaris, a two-phase regimen (secretome-HA 18 µg/day for 15 days followed by 70 µg/day) demonstrated:

• 33 percent reduction in modified Psoriasis Area and Severity Index (mPASI) scores
• 41 percent reduction in plaque size
• 30 to 38 percent improvement in transepidermal water loss
• 43 percent increase in skin elasticity

Two patients experienced full remission of psoriatic lesions. Safety evaluations included 96-hour patch testing in individuals with atopic dermatitis and 15-day self-application in healthy volunteers at doses up to 210 µg/day. No systemic toxicity or local reactions were observed, even in hypersensitive individuals, supporting the formulation’s tolerability profile.

Microbiological testing confirmed the lyophilized sponge’s sterility after three months of storage at room temperature, underscoring its feasibility for distribution and use without specialized refrigeration.

Implications and Next Steps

This sponge-based approach offers a regenerative treatment for psoriasis vulgaris through a stable, non-invasive alternative that patients can self-administer. Its ease of use, favorable safety profile, and cell-free design position it as a potential candidate for broader clinical application. Larger, longer-term trials are needed to validate its therapeutic impact, optimize dosing, and evaluate its role alongside standard treatment regimens.

Reference:

1. Elgueta E, Prieto CP, Hartmann D, et al. Novel sponge formulation of mesenchymal stem cell secretome and hyaluronic acid: a safe and effective topical therapy for Psoriasis vulgaris. Stem Cell Res Ther. 2025;16(1):348. Published 2025 Jul 6.