Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Translational Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Cell Transplant. 2020 Jan-Dec;29:963689720968495. doi: 10.1177/0963689720968495.
Osteoarthritis (OA) is a major cause of disability worldwide with increasing age. Knee OA (KOA) is the most prevalent type of OA. Recently, it is considered that KOA is a whole joint disease, including articular cartilage, subchondral bone, synovium, ligaments, joint capsules, and muscles around the joint. Exosomes in knee joint are mainly secreted by articular chondrocytes and synoviocytes. They participate in cell and tissue cross-talk by carrying a complex cargo of proteins, lipids, nucleic acids, etc. Under normal conditions, exosomes maintain the microenvironmental homeostasis of the joint cavity. Under pathological conditions, the composition and function of exosomes changes, which in turn, disrupts the balance of anabolism and catabolism of articular chondrocyte and facilitates inflammatory responses, thus accelerating KOA progression. As a regenerative medicine, mesenchymal stem cells (MSCs) are promised to facilitate repair of degenerated cartilage and decelerate OA process. The therapeutic function of MSC mainly depends on MSC-derived exosomes, which can restore the homeostasis of the articular microenvironment. In the future, the specific mechanism of exosomes for OA treatment needs further elucidation, and the treatment effect of exosomes for long-term and/or severe OA needs further exploration.
骨关节炎（OA）是全球范围内导致残疾的主要原因，且随着年龄的增长而增加。膝骨关节炎（KOA）是最常见的 OA 类型。最近，人们认为 KOA 是一种全关节疾病，包括关节软骨、软骨下骨、滑膜、韧带、关节囊和关节周围的肌肉。膝关节中的外泌体主要由关节软骨细胞和滑膜细胞分泌。它们通过携带蛋白质、脂质、核酸等复杂货物参与细胞和组织间的通讯。在正常情况下，外泌体维持关节腔的微环境稳态。在病理条件下，外泌体的组成和功能发生改变，进而破坏关节软骨细胞的合成代谢和分解代谢平衡，并促进炎症反应，从而加速 KOA 的进展。作为一种再生医学，间充质干细胞（MSCs）有望促进退变软骨的修复并减缓 OA 进程。MSC 的治疗功能主要依赖于 MSC 衍生的外泌体，其可以恢复关节微环境的稳态。未来，需要进一步阐明外泌体治疗 OA 的具体机制，还需要进一步探索外泌体治疗长期和/或严重 OA 的效果。
