1. Introduction
Atopic dermatitis (AD) is a chronic and relapsing skin disorder characterized by cutaneous inflammation and defects in the epidermal barrier function [
1]. It is one of the most common skin disorders, estimated to be present in up to 1–3% of adults and 20% of children worldwide [
2]. The pathophysiology of AD remains unclear, although epidermal barrier dysfunction due to immunological responses and genetic defects plays an important role in the deterioration and development of AD [
1].
AD in dogs is an allergic skin disease with a prevalence of 10–15% and many similarities with human AD [
3]. The cause of the onset of canine AD remains unclear, although it is usually presumed to be due to skin barriers or immunological changes resulting from various interactions, such as an imbalance in immune function, as in humans [
3,
4,
5]. Currently, canine AD drugs have different clinical efficacy in different breeds, potentially because multiple gene abnormalities and altered immunological processes can be involved [
3,
6]. In addition, steroids should be used for moderate or high forms of AD, which have serious side effects; therefore, the development of safe and effective drugs is continuously being studied [
7]. Thus, there is a trend to utilize stem cell treatments or various new technologies for the treatment of canine AD.
Mesenchymal stem cells (MSCs) are self-regenerative cells with the potential to differentiate into multiple cell types [
8]. MSCs are present in various tissues, such as bone marrow, fat, umbilical cord, and kidney, and can differentiate into osteoblasts, adipose cells, and muscle cells. [
9,
10] Since MSCs were established, cell therapy using them has been reported in various disease models, including autoimmune diseases [
11], myocarditis [
12], and glomerulonephritis [
13]. MSCs also have the immunomodulatory ability to regulate the inhibition of Th2 cells and increase regulatory T (Treg) cells [
14]. In particular, MSCs do not have major histocompatibility complex (MHC) II, while co-stimulatory molecules, such as CD80 and CD86 play an important role in allogeneic antigen recognition [
15]. Therefore, because the immunogenicity of MSCs is relatively low, the therapeutic effect of immunomodulatory action can be clinically expected [
16].
Recent studies have shown that MSCs exert an immunosuppressive effect by producing and releasing extracellular vesicles (EVs) of various sizes, which consist of lipid bilayers rather than through cell-to-cell contact [
17]. EVs are considered essential carriers of cellular communication molecules, which encapsulate a variety of genetic materials. MSC-derived EVs (MSC-EVs) contain regulatory molecules capable of modulating immune cell functions [
18]. MSC-EVs have also been shown to have immunomodulatory abilities similar to those found in MSCs [
18].
EVs are nanosized vesicles (approximately 30–200 nm in size) that play an important role in cell-to-cell communications [
17]. Alix and TSG101, which are known to exist inside EVs, and CD63, CD9, and CD81, which are present on the surface of EVs, are well-known as specific markers [
18]. In addition, it is known that there is a difference in expression levels depending on the cell of origin. Stem cell-derived EVs contain a large number of molecules related to the regeneration/healing, anti-inflammatory, and immunomodulatory abilities of stem cells; therefore, research is underway for the development of a next-generation non-cell therapy [
19]. Specifically, MSC-EVs have been shown to have broad anti-inflammatory and regenerative effects in an array of inflammatory disease models, including atopic disease [
19].
It is difficult to accurately identify the trends in the animal cell therapy market because global market analysis has not been conducted properly. However, there are several confirmed reports on the therapeutic effects of EVs from adipose-derived stem cells in horses and dogs with arthritis [
20]. Therefore, there is potential for using EVs to treat diseases in animals.
In the present study, we isolated canine adipose stem cell (cASC)-derived EVs and characterized them. We also investigated whether cASC-EVs improved AD-like dermatitis in an animal model and addressed the safety concern in systemic toxicity studies using ICR mice. In addition, we performed next-generation sequencing (NGS) to study the role of miRNAs in improving inflammatory responses.
2. Materials and Methods
2.1. Isolation and Cultivation of Canine ASCs (cASCs)
Canine adipose tissue was obtained from Knotus Co., Ltd. (Incheon, Republic of Korea). Ten individual beagles at one year of age were used. In brief, the adipose tissue was chopped, and an aliquot was enzymatically digested at 37 °C for 1 h with 1% type 2 collagenase (Sigma, St. Louis, MO, USA) in phosphate-buffered saline (PBS), using a shaking incubator. The digested adipose tissue was centrifuged at 1000 rpm for 5 min, and the pellet was resuspended and passed through a 70 µm mesh filter (Cell Strainer, Becton Dickinson, Franklin Lakes, NJ, USA) to remove the debris. Cells were plated in 100 mm culture dishes at mononuclear cells with Dulbecco’s Modified Eagle Medium: Nutrient Mixture F-12 (DMEM/F12) containing 10% fetal bovine serum (FBS) and antibiotics (100 U/mL penicillin G and 100 µg/mL streptomycin). After one day, the medium was changed to remove non-adherent cells, while the adhered cells were expanded for five days and subcultured [
21].
2.2. Fluorescence-Activated Cell Sorting (FACS) Analysis
Phenotypical characterization of cASCs (passage No. 3) was performed using a flow cytometer (Agilent, St. Clara, CA, USA, NovoCyte 3000). ASCs were removed via trypsinization, placed on ice for 30 min, and treated with the following labeled stemness-associated antigen markers: CD29+, CD44+, CD90+, CD105+, CD4−, CD8−, CD14−, CD25−, CD45−, CD80−, CD184−, and MHCII−. Other antibodies with the indicated specifications were purchased separately: CD29+ (Thermo Fisher Scientific, MA1-19458), CD44+ (Thermo Fisher Scientific, 11-5440-42), CD90+ (Thermo Fisher Scientific, 12-5900-42), CD4 (Thermo Fisher Scientific, MA5-16989), CD8 (Thermo Fisher Scientific, 17-5080-42), CD14 (BD, 555397), CD25 (Thermo Fisher Scientific, 63-0250-42), CD45 (Thermo Fisher Scientific, 48-5450-42), CD80− (Thermo Fisher Scientific, 46-0801-82), and CD184− (Thermo Fisher Scientific, 12-9991-82) [
22].
2.3. Reverse Transcription Polymerase Chain Reaction (RT-PCR) for Phenotypical Characterization of cASCs
Total RNA was extracted from fresh cells (cASCs and CMT-U27; canine mammary cancer cell lines for comparison) using the RNA extraction Hybrid-R kit (GeneAll, 305-101). RNA concentration was measured at an absorbance of 260 nm with a spectrophotometer (Thermo Fisher Scientific, Waltham, MA, USA), and cDNA was synthesized from total RNA using the PrimeScript RT reagent kit with gDNA Eraser (TOYOBO, FSQ-301), according to the manufacturer’s protocol. The expression of specific genes was quantified by RT-PCR, in accordance with the instructions of i-StarMAX II ™ DNA Polymerase (iNtRON Biotechnology, 25173). The primer sequence is as follows. SOX2, F: ACAGCATGTCCTACTCGCAG, R: GGACTTGACCACCGAGCC; Nanog, F: CCAGACCTGGAACAGCCAAT, R: ACAGTTGTGGAGCGGATTGT; Oct4, F: GACACCTCCCAGCCGGA, R: TGCTCCAGCTTCTCCTTGTC; GAPDH, F: GTTTGTGATGGGCGTGAACC, R: TTTGGCTAGAGGAGCCAAGC.
For multipotency marker analysis, target genes were amplified at 94 °C (2 min), 35 cycles of 94 °C (10 s), 60 °C (10 s), 72 °C (10 s), followed by 72 °C for 7 min. PCR products were separated on a 2% agarose gel by electrophoresis, stained with Red Safe (iNtRON Biotechnology, Seongnam, Republic of Korea) and visualized under UV light. Images were digitally captured using an iBright™ CL1500 Imaging System (Invitrogen™, Waltham, MA, USA).
2.4. Osteogenic Differentiation: Alizarin Red Staining
Osteogenesis differentiation medium (Osteogenic Differentiation SingleQuotsTM Supplements Kit; Lonza) was used according to the manufacturer’s instructions. ASCs were cultured for 21 days, the medium was changed every 3rd day, and differentiation was assessed using alizarin red staining. For this process, the cells were fixed with 4% formaldehyde solution for 30 min, followed by rinsing with PBS, and incubation with alizarin red solution in the dark for 30 min. Then, the cells were washed several times with PBS and visualized under a light microscope. Red staining indicates the deposition of calcium phosphate precipitates by osteoblasts [
23].
2.5. Chondrogenic Differentiation: Alcian Blue Staining
Chondrogenic differentiation medium (Chondrogenic SingleQuot Kit; Lonza, Basel, Swizerland) was used according to the manufacturer’s instructions. ASCs were cultured for 28 days, the medium was changed every 3rd day, and differentiation was assessed using Alcian blue staining. Cells were fixed with 4% formaldehyde for 30 min and washed with PBS. Then, 1% Alcian blue, which was prepared in 0.1 N HCl, was added for 30 min incubation, and distilled water was added. Blue staining indicated chondrocyte synthesis of proteoglycans [
23]. Additionally, the pellet culture in 15 mL conical tubes was observed for 35 days. The pellet was stained after paraffin sectioning.
2.6. Adipogenic Differentiation: Oil Red O Staining
An adipogenesis differentiation kit (Adipogenic Induction SingleQuot Kit, Lonza) was used according to the manufacturer’s instructions. ASCs were cultured for 35 days. Cells were cultured with cASCs in supplemented adipogenesis induction medium and cultured for 3 days (37 °C and 5% CO2) followed by 1–3 days of culture in supplemented adipogenic maintenance medium. These cycles were repeated three times. The cells were cultured for 7 days in a supplemented adipogenic maintenance medium. Differentiation was assessed by the presence of lipid droplets, which were visualized after staining with Oil Red O solution. Cells were fixed with 10% formal calcium fixative for 60 min, washed with PBS, and then with 70% ethanol. The addition of Oil Red O solution was followed by rinsing the cells with 70% ethanol, followed by tap water. Red staining indicates the presence of lipids.
2.7. Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR) for Analysis of Differentiation
Total RNA was extracted from fresh cells using an RNA extraction Hybrid-R kit (GeneAll, 305-101). RNA concentration was quantified by measuring absorbance at 260 nm with a spectrophotometer (Thermo Fisher Scientific, Waltham, MA, USA), and cDNA was synthesized from total RNA using a PrimeScript RT reagent kit with a gDNA Eraser (TOYOBO, FSQ-301), according to the manufacturer’s protocol. Then, the expression of our chosen genes was quantified by RT-PCR, in accordance with the instructions of the qPCRBIO SyGreen Blue Mix Separate-Rox (PCR Biosystems, PB20.17-05). The primer sequence is as follows. BMP2, F: CGGGAACAGATGCAGGAACC, R: AAAGTCTGGTCACGGGGAAC; RUNX2, F: TGCTTCATTCGCCTCACAAAC, R: GACTCTGTTGGTCTCGGTGG; OPN, F: AGGGACAGCCATGCAAAAGA, R: TACTCTTGGGAGTGCTTGCG; SOX9, F: CTACATGAACCCCGCGCAGA, R: GTGTGTAGACAGGCTGTTCCC; Aggrecan, F: AGAAGCCCTTCACTTTCGCC, R: CTCTCCAGTCCTGTTCTCGG; FAS, F: CTGCACGTCTTATGCGGGTA, R: TGCTCTCCATCGCAGATTCC; SREBP-1, F: TGCACGACTGCCAGCAAA, R: CGCGGACGGGGATCTA; GAPDH, F: GTTTGTGATGGGCGTGAACC, R: TTTGGCTAGAGGAGCCAAGC.
Reactions were performed using a CFX96 Touch Real-Time PCR Detection System (Bio-Rad, Hercules, CA, USA) with the following process steps: 95 °C for 2 min, 40 cycles of 95 °C for 10 s, and 60 °C for 20 s, followed by melting curve analysis. The specificities of the PCR products were verified by melting curve analyses between 65 and 95 °C. At the end of each reaction, CT values were obtained by analyzing the fluorescence data. Gene expression was calculated using the 2−∆∆Ct method, where the values from different samples were averaged and calibrated in relation to GAPDH CT values.
2.8. Isolation of cASC-EVs
cASC-Evs were isolated from cASC-conditioned media (CM) by tangential flow filtration (TFF)-based ExoSCRT™ technology, as previously described [
24]. Briefly, CM was filtered through a 0.22 μm polyethersulfone membrane filter (Merck Millipore, Billerica, MA, USA) to remove non-exosomal particles, such as cells, cell debris, microvesicles, and apoptotic bodies. Then, the CM was concentrated by tangential flow filtration with a 500 kDa molecular weight cut-off filter membrane cartridge (Cytiva, Chicago, IL, USA), and buffer exchange was performed by diafiltration with DPBS. The amount of protein in isolated cASC-EVs was approximately 0.5% of the amount of protein in the CM. Isolated cASC-EVs were aliquoted into polypropylene disposable tubes and stored at −80 °C until use. Before use, frozen cASC-Exos were left at 4 °C until completely thawed and were not frozen again. Characterization and profile analysis of the cASC-EVs were conducted following the Minimal Information for Studies of Extracellular Vesicles 2018 (MISEV2018), recommended by the International Society for Extracellular Vesicles (ISEV) [
17].
The cASC-EVs used for analysis and AD treatment in this study were derived from passage 3 cASC and isolated from the CM collected under the same culture conditions for two days.
2.9. Quantification of cASC-EVs
To determine size distribution and particle concentration, cASC-EVs were diluted with DPBS and analyzed by nanoparticle tracking analysis (NTA) using a NanoSight NS300 (Malvern Panalytical, Amesbury, UK) equipped with a 642 nm laser. Then, the cASC-EVs were diluted with DPBS to between 20 and 80 particles per frame and scattered and illuminated by the laser beam, while their movements under Brownian motion were captured for 20 s each, at a camera level of 16. The subsequent videos were analyzed by NTA 3.2 software using constant settings. To provide a representative result, at least five videos were captured, and more than 2000 validated tracks were analyzed for each individual sample. The NTA instrument was regularly checked with 100 nm standard beads (Thermo Fisher Scientific). To provide a representative size distribution of the EVs, the size distribution profiles from each video replicate were averaged.
Protein quantification of cASC-EVs determined using the Micro BCA protein assay kit (Thermo Fisher Scientific, Waltham, MA, USA) according to the manufacturer’s protocol.
2.10. Bead-Based Flow Cytometric Analysis of Exosomal Surface Markers
The isolated cASC-EVs were captured and labeled with Dynabeads, according to the manufacturer’s instructions. Briefly, 2 μg of cASC-EVs were incubated overnight at 4 °C with capture beads. The captured EVs were labeled with a mixture of APC-conjugated anti-CD81 antibodies for 1 h at room temperature. The bead populations and APC intensities were analyzed using a NovoCyte 2000 R Flow Cytometer (ACEA Biosciences, San Diego, CA, USA), and the data were analyzed using NovoExpress software (ACEA Biosciences). The background was corrected with the median intensity of the anti-IgG-APC signals. Assays were performed in triplicate for three independent samples.
2.11. In Vivo Efficacy Study
2.11.1. Animals and Study Design
Animal care and experimental procedures were approved by the Institutional Animal Care and Use Committee of the Korea Conformity Laboratories (IACUC number: IA20-02200). Male 6-week-old NC/Nga mice were obtained from Central Lab Animal, Inc. (Seoul, Republic of Korea). The mice were divided into six groups (n = 8 per group) as follows: the normal group (Ctrl group), Df-induced with no treatment group (AD group), Df-induced with EV treatment groups (1.00 × 109, 3.33 × 109, and 1.00 × 1010 particles/mL), and Df-induced with prednisolone treatment group (10 mg/kg). To induce AD-like skin lesions, 100 mg Dermatophagoides farinae ointment (Df; Biostir®-AD cream, Kobe, Japan) was applied to the shaved dorsal skin, 2 h after the 4% sodium dodecyl sulfate application (SDS, Sigma-Aldrich, St. Louis, MO, USA), twice a week, for 3 weeks in NC/Nga mice, and EVs were administered subcutaneously (SC) into the loose skin over the neck 3 times a week for 4 weeks. As a positive control, prednisolone was orally administered daily. In the seventh week, the mice were sacrificed, and skin and blood samples were collected. The experimental design is illustrated in Figure 4A.
2.11.2. Clinical Observation of AD
Clinical observation of the backs of NC/Nga mice was performed once a week for 4 weeks. To compare the skin lesions of the mice, the clinical severity of dermatitis was scored using the previously described macroscopic diagnostic criteria, which are normally used for human AD. Briefly, dermatitis severity was evaluated once per week. The development of (1) erythema/hemorrhage, (2) scarring/dryness, (3) edema, and (4) excoriation/erosion was scored as 0 (none), 1 (mild), 2 (moderate), and 3 (severe), respectively. The sum of individual scores was used as the dermatitis score. Ear thickness was measured using a caliper (Mitutoyo, 209-572M External Digital Caliper Gauge (0–20 mm, 0.01 mm); Myanmar) 4 weeks after Df-induction [
25].
2.11.3. Total Serum IgE Measurement
Total serum IgE levels were measured using a mouse IgE ELISA kit (ab157718; Abcam, Waltham, MA, USA), according to the manufacturer’s instructions. Serum samples were obtained by centrifugation at 12,000 rpm for 10 min and stored at −80 °C until required for the assay.
2.11.4. Quantitative Real-Time PCR Analysis
After the administration of EVs for four weeks, skin lesions from the back were removed, frozen immediately in liquid nitrogen, and stored at −80 °C. The mRNA levels of the inflammatory cytokines were analyzed using RT-qPCR. RNA extraction was performed by disrupting 20 mg or less of tissue with a homogenizer, followed by RNA extraction using the AccuPrep® Universal RNA Extraction Kit (Bioneer, Daejeon, Republic of Korea, Cat.K-3140) and DNase treatment using the RNase-Free-DNase Set (Qiagen, Hilden, Germany, Cat.79254). RNA quality, concentration, and purity were measured with a NanoDrop One (Thermo Fisher Scientific), and an 18S/28S peak was confirmed with a 5200 Fragment Analyzer (Agilent). RT-qPCR was performed using 48 ng RNA for the AccuPower®GreenStar™ RT-qPCR Master Mix (Cat.K-6403) and Exicycler TM 384 Real-Time Quantitative Thermal Block (Cat.A-2061). Primers were provided by Bioneer (Il4, 146 bp; primer no. PM00287, Gene Bank NM_021283; Il5, 110 bp, primer no. PM00178, Gene Bank NM_010558; Il13, 212 bp, primer no. PM00288, Gene Bank NM_008355; Ifng, 156 bp, primer no. PM00289, Gene Bank NM_008337; Gapdh, 146 bp, primer no. PM00118, Gene Bank NM_001289726, NM_008084).
2.11.5. Histopathologic Evaluation
The tissues of the experimental mice were removed, fixed in 10% phosphate-buffered formalin, embedded in paraffin, sectioned, and stained with H&E. To measure mast cell infiltration, paraffin-embedded tissue sections were stained with toluidine blue, and the number of mast cells was counted at five random sites.
2.11.6. Immunohistochemistry
Serial sections of paraffin-embedded skin were deparaffinized and incubated with an anti-TSLP (10 μg/mL; ab115700; Abcam) and CD-86(4 μg/mL; ab213044; Abcam) at 4 °C for 24 h after being blocked with normal goat serum. The slides were incubated with a biotinylated secondary antibody for 1 h, followed by avidin–biotin–peroxidase complexes (Envision kit; Dako, K5007, Glostrup, Denmark) for 2 h. Peroxidase activity was confirmed using 3,3-diaminobenzidine (Vector Labs, Newark, CA, USA) followed by a hematoxylin counterstain. The stained cells were counted in each group. The staining intensity for TSLP and CD-86 was scored on a 5-point scale as follows: 0, no positive staining; 1+, mild cytoplasmic staining; 2+, moderate-to-severe cytoplasmic staining; 3+, moderate-to-severe cytoplasmic staining with nuclear staining; 4+, severe cytoplasmic staining [
25].
2.12. In Vivo Toxicity Studies
2.12.1. Single-Dose Toxicity Study
This toxicity study began after approval of the IACUC of KCL (approval number: IA19-01714). The aim of this study was to investigate the toxicity symptoms and the approximate lethal dose. Briefly, 8-week-old, ICR mice (OrientBio, Seongnam, Republic of Korea) were randomly assigned to four groups of ten animals (five male and five female mice per group). The cASC-EVs were subcutaneously administered once each to the male and female ICR mice at doses of 7.45 × 108 (low dose), 2.98 × 109 (mid-dose), and 1.19 × 1010 (high dose) particles/20 g and compared to the vehicle control group, only treated with DPBS. During the experiment, the occurrence of dead animals, symptoms, and changes in bodyweight were noted, and the overall gross findings from the sacrificed animals were observed at the end of the experiment.
2.12.2. Twenty-Eight-Day Repeat-Dose Toxicity Study
This study was conducted to evaluate the potential toxicity and the organs being targeted when the cASC-EVs were repeatedly administered to ICR female and male mice for 4 weeks. All animal experiments were approved by the IACUC of KCL (approval number: IA21-02194). Briefly, 8-week-old, ICR mice (OrientBio, Seongnam, Republic of Korea) were randomly assigned to four groups of twenty animals (ten male and ten female mice per group). The cASC-EVs were subcutaneously administered at doses of 7.45 × 108 (low dose), 2.98 × 109 (mid-dose), and 1.19 × 1010 (high dose) particles/20 g 3 times a week. Mortality, clinical observation, bodyweight change, food consumption, water intake, urinalysis, hematology, blood chemistry, necropsy findings, organ weight, and histopathological findings were evaluated during the experiment. Hematological evaluation was measured using a blood analyzer (ADVIA 2120, SIEMENS, Munich, Germany) and blood chemistry evaluation was performed using a blood biochemical analyzer (Hitachi 7180, HITACHI, Tokyo, Japan).
2.13. microRNA Profiling
Raw reads of small RNAs were preprocessed to eliminate adapter sequences. Adapters in the raw reads were trimmed using the Cutadapt program. The first three nucleotides of all reads were trimmed to remove extra bases that were inserted during the SMART template-switching activity process. If a sequence was matched to more than the first 5 bp of the 3’ adapter sequence, it was regarded as an adapter sequence and trimmed from the read. Trimmed reads longer than 18 bp were selected for mapping reliability. Then, the remaining reads were classified into non-adapter reads, whose adapter sequences were not sequenced. Trimmed and non-adapter reads were combined and regarded as processed reads for downstream analysis.
To minimize sequence redundancy for computational efficiency, the processed reads were clustered by a sequence. A unique cluster consists of reads with the same sequence and length. To eliminate rRNA, the reads aligned to the 45S pre-rRNA and mitochondrial rRNA from Canis lupus familiaris were excluded.
Sequence alignment and detection of known and novel miRNAs were performed using the miRDeep2 software algorithm. The rRNA-filtered reads were aligned to the mature and precursor miRNAs of Canis lupus familiaris obtained from miRBase v22.1 using the miRDeep2 quantifier module. The miRDeep2 algorithm is based on the miRNA biogenesis model; it aligns reads to potential hairpin structures to check whether their mapping context is consistent with Dicer processing and assigns scores representing the probability that hairpins are true miRNA precursors.
The reference genome of Canis lupus familiaris, released as CanFam3.1, was retrieved from RefSeq. The reference genome was indexed, and rRNA-filtered reads were mapped using Bowtie (1.1.2). Novel miRNAs were predicted from mature, star, and loop sequences, according to the RNAfold algorithm, using miRDeep2. The RNAfold function uses a nearest-neighbor Thermodynamic model to predict the minimum free-energy secondary structure of an RNA sequence.
Uniquely clustered reads were sequentially aligned to the reference genome, miRBase v22.1, and the non-coding RNA database RNAcentral release 14.0 to identify the known miRNAs and the other RNA types for classification.
For the bioinformatic analysis of miRNAs, predicted targets of miRNAs with a score of 75 or higher were selected from the miRDB database (
http://miRDB.org, accessed on 30 April 2021). The gene ontology (GO) analysis of the targets was performed using DAVID 6.8 (
https://david.ncifcrf.gov/home.jsp, accessed on 9 June 2023).
2.14. Statistical Analysis
All quantitative data are reported as means ± standard deviation. Between-group comparisons were performed using the two-tailed Student t-test or ANOVA, followed by Tukey’s test for normally distributed variables, or nonparametric analysis with a Mann–Whitney U-test or Kruskal–Wallis test, followed by Dunn’s multiple comparison test for nonnormally distributed variables. p < 0.05 was considered statistically significant.
4. Discussion
Human MSCs are known to regulate inflammatory relief and immune activation through the secretion and interaction of EVs, growth factors, and various cytokines [
30,
31]. In particular, MSC-EVs are known to contain abundant substances such as proteins, lipids, and miRNAs, and are attracting attention as a leader in cell-free therapy as an alternative to cell therapy [
32]. Recent studies have reported that it is related to various immunological diseases, such as allergic reactions, asthma, and AD [
33]. Additionally, various studies have shown that MSC-EVs play a major role in immunosuppression. In the field of cell therapy, the development of treatments using MSCs is an important topic, yet issues related to immunogenicity and side effects are emerging as the biggest problems in cell therapy [
34]. The development of treatments using MSC-EVs has been suggested as a good alternative to reduce the side effects [
35]. Therefore, many studies have been conducted to alleviate symptoms of AD, such as itchiness, skin barrier defects, and inflammation through MSC-EVs [
36].
However, in the case of canine AD, few studies have investigated treatments using canine MSCs. Therefore, there are few treatments for AD or other inflammatory diseases using canine-MSCs [
24]. We are interested in the treatment of inflammation using cASC-EVs, particularly in the treatment of atopy. Here, we separated canine MSCs from adipose tissue, verified the cells, and isolated EVs from the cells. We previously identified the anti-inflammatory effect of human MSC-EVs by investigating the therapeutic effect of AD from human MSC-EVs [
26]. Accordingly, we hypothesized that confirming the anti-inflammatory effect of canine MSC-EVs could lead to the same concept. Previously, there were only a few studies using characteristic canine AD models other than DNBC-treated models, and it was expected that using cASC-EVs would have a promising effect on the treatment of canine AD [
24].
In the Biostir-induced AD model, we confirmed both a reduction in inflammation-related factors and the reduction of AD-related levels in a dose-dependent manner following treatment with cASC-EVs. This result indicates that the inflammatory environment of AD mice is regulated by the activation of T cells and mast cells, thereby reducing the inflammatory response in the Biostir-induced AD model. In addition, the reduction of serum inflammation-related cytokines, such as IL-4 and IFN-gamma, demonstrated the effectiveness of cASC-EVs in the treatment of AD. In general, IL-4 and IFN-gamma strongly inhibit the expression of barrier-related molecules that play an important role in maintaining the structural integrity and function of the stratum corneum of the skin and allow the stratum corneum to be maintained [
37]. Through this, it was confirmed that the reduction in the same inflammation-related factors occurred in both human ASC-EVs and in dogs.
In addition, the increase in serum IgE levels in the Biostir-induced AD model was remarkably reduced by treatment with cASC-EVs. This result indicated that cASC-EVs inhibited skin inflammation in the Biostir-induced AD model through T-cell activation and mast cells. Thus, it was possible to confirm the regulation of immune cell activation by cASC-EVs. Similarly, TSLP and CD86 [
38], which are indicators of inflammatory diseases, including in AD models, were decreased in a concentration-dependent manner by cASC-EVs, confirming that cASC-EVs exhibit anti-inflammatory effects.
From the single-dose and 28-day repeat-dose toxicity studies, the potential toxicity and target organs were not observed when cASC-EVs were subcutaneously administered to ICR mice under test conditions. Therefore, the NOAEL (no observed adverse effect level) of cASC-EVs is considered to be 1.19 × 1010 particles/20 g (the highest dose).
Although EVs have been studied for many years, the biological roles of EV-miRNAs have only recently been investigated [
39]. Our data showed that 798 miRNAs were identified and profiled using thermal map analysis. We analyzed the top 20 most highly expressed miRNAs in cASC-EVs. Among the various miRNAs, let-7a, let-7b, and miR-21 were highly expressed in cASC-EVs. These miRNAs, which are abundant in cASC-EVs, are known to exert anti-inflammatory effects in recipient cells through miRNA transfer [
40,
41,
42]. Since let-7b and miR-21 have been shown to regulate inflammation in various contexts, our findings provide new insights into how and where they function, allowing us to better understand how they regulate inflammation-related processes. Furthermore, our study adds to the promising body of evidence which highlights that miRNA transfer within EVs is part of an intercellular communication network that coordinates complex immune responses [
43,
44].