Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
Department of Polymer Engineering, Islamic Azad University, Sarvestan, Iran.
Adv Exp Med Biol. 2021;1326:73-93. doi: 10.1007/5584_2021_625.
Osteoarthritis (OA) and other degenerative joint diseases are characterized by articular cartilage destruction, synovial inflammation, sclerosis of subchondral bone, and loss of extracellular matrix (ECM). Worldwide, these diseases are major causes of disability. Cell therapies have been considered to be the best therapeutic strategies for long-term treatment of articular cartilage diseases. It has been suggested that the mechanism of stem cell-based therapy is related to paracrine secretion of extracellular vesicles (EVs), which are recognized as the main secretion factors of stem cells. EVs, and in particular the subclass exosomes (Exos), are novel therapeutic approaches for treatment of cartilage lesions and OA. The results of recent studies have shown that EVs isolated from mesenchymal stem cells (MSCs) could inhibit OA progression. EVs isolated from various stem cell sources, such as MSCs, may contribute to tissue regeneration of the limbs, skin, heart, and other tissues. Here, we summarize recent findings of preclinical and clinical studies on different MSC-derived EVs and their effectiveness as a treatment for damaged cartilage. The Exos isolation techniques in OA treatment are also highlighted.
骨关节炎（OA）和其他退行性关节疾病的特征是关节软骨破坏、滑膜炎症、软骨下骨硬化和细胞外基质（ECM）丢失。在全球范围内，这些疾病是导致残疾的主要原因。细胞疗法被认为是治疗关节软骨疾病的最佳治疗策略。有研究表明，基于干细胞的治疗机制与细胞外囊泡（EVs）的旁分泌有关，EVs 被认为是干细胞的主要分泌因子。EVs，特别是外泌体（Exos），是治疗软骨损伤和 OA 的新型治疗方法。最近的研究结果表明，从间充质干细胞（MSCs）中分离出的 EVs 可以抑制 OA 的进展。从各种干细胞来源（如 MSCs）分离出的 EVs 可能有助于四肢、皮肤、心脏和其他组织的组织再生。在这里，我们总结了关于不同 MSC 来源的 EVs 及其作为受损软骨治疗方法的有效性的临床前和临床研究的最新发现。还强调了 OA 治疗中外泌体的分离技术。
