Improvement of androgenic alopecia by extracellular vesicles secreted from hyaluronic acid-stimulated induced mesenchymal stem cells

• HA-primed iMSC-derived EVs (HA–iMSC–EVs) significantly improve androgenic alopecia by blocking testosterone-induced upregulation of AR, TGF-β, and IL-6 in dermal papilla cells. • HA–iMSC–EVs reactivate the Wnt/β-catenin pathway via β-catenin stabilization and increased phosphorylated GSK3β, promoting hair regrowth. • In a testosterone-induced AGA mouse model, HA–iMSC–EVs restored hair growth more effectively than unprimed iMSC–EVs, comparable to finasteride. • Scalable production of iMSCs combined with HA priming offers a promising cell-free therapeutic strategy for AGA with enhanced efficacy.