Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, China.
Biomed Res Int. 2019 Aug 4;2019:1983131. doi: 10.1155/2019/1983131. eCollection 2019.
Nonunion with bone defects, a common complication after long bone fracture, is a major challenge for orthopaedic surgeons worldwide because of the high incidence rate and difficulties in achieving successful treatment. Bone defects are the main complications of nonunion. The conventional biological treatments for nonunion with bone defects involve the use of autologous bone grafts or bone graft substitutes and cell-based therapy. Traditional nonunion treatments have always been associated with safety issues and various other complications. Bone grafts have limited autologous cancellous bone and there is a risk of infection. Additionally, problems with bone graft substitutes, including rejection and stimulation of bone formation, have been noted, and the health of the stem cell niche is a major consideration in cell-based therapy. In recent years, researchers have found that exosomes can be used to deliver functional RNA and mediate cell-to-cell communication, suggesting that exosomes may repair bone defects by regulating cells and cytokines involved in bone metabolism. In this review, we highlight the possible relationships between risk factors for nonunion and exosomes. Additionally, we discuss the roles of exosomes in bone metabolism and bone regeneration.
骨不连伴骨缺损是长骨骨折后常见的并发症，由于其高发生率和治疗成功的困难，成为全球骨科医生面临的主要挑战。骨缺损是非骨不连的主要并发症。传统的生物治疗方法包括使用自体骨移植或骨移植替代物和基于细胞的治疗。传统的非骨不连治疗方法一直存在安全性问题和各种其他并发症。骨移植的自体松质骨有限，存在感染风险。此外，骨移植替代物也存在排斥和刺激骨形成等问题，基于细胞的治疗中，干细胞龛的健康是一个主要的考虑因素。近年来，研究人员发现外泌体可以用于传递功能 RNA 并介导细胞间通讯，这表明外泌体可能通过调节参与骨代谢的细胞和细胞因子来修复骨缺损。在这篇综述中，我们强调了非骨不连的危险因素与外泌体之间可能存在的关系。此外，我们还讨论了外泌体在骨代谢和骨再生中的作用。
