Li Weihang, Zhang Shilei, Wang Dong, Zhang Huan, Shi Quan, Zhang Yuyuan, Wang Mo, Ding Ziyi, Xu Songjie, Gao Bo, Yan Ming
Department of Orthopedic Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China.
Department of Orthopaedics, Affiliated Hospital of Yanan University, Yanan, China.
Front Cell Dev Biol. 2022 Feb 10;9:822149. doi: 10.3389/fcell.2021.822149. eCollection 2021.
Low back pain (LBP), which is one of the most severe medical and social problems globally, has affected nearly 80% of the population worldwide, and intervertebral disc degeneration (IDD) is a common musculoskeletal disorder that happens to be the primary trigger of LBP. The pathology of IDD is based on the impaired homeostasis of catabolism and anabolism in the extracellular matrix (ECM), uncontrolled activation of immunologic cascades, dysfunction, and loss of nucleus pulposus (NP) cells in addition to dynamic cellular and biochemical alterations in the microenvironment of intervertebral disc (IVD). Currently, the main therapeutic approach regarding IDD is surgical intervention, but it could not considerably cure IDD. Exosomes, extracellular vesicles with a diameter of 30-150 nm, are secreted by various kinds of cell types like stem cells, tumor cells, immune cells, and endothelial cells; the lipid bilayer of the exosomes protects them from ribonuclease degradation and helps improve their biological efficiency in recipient cells. Increasing lines of evidence have reported the promising applications of exosomes in immunological diseases, and regarded exosomes as a potential therapeutic source for IDD. This review focuses on clarifying novel therapies based on exosomes derived from different cell sources and the essential roles of exosomes in regulating IDD, especially the immunologic strategy.
腰痛（LBP）是全球最严重的医学和社会问题之一，影响了全球近80%的人口，而椎间盘退变（IDD）是一种常见的肌肉骨骼疾病，恰好是腰痛的主要诱因。IDD的病理基于细胞外基质（ECM）中分解代谢和合成代谢的内稳态受损、免疫级联反应的失控激活、髓核（NP）细胞的功能障碍和丧失，以及椎间盘（IVD）微环境中的动态细胞和生化改变。目前，针对IDD的主要治疗方法是手术干预，但它并不能有效治愈IDD。外泌体是直径为30-150nm的细胞外囊泡，由干细胞、肿瘤细胞、免疫细胞和内皮细胞等多种细胞类型分泌；外泌体的脂质双层保护它们免受核糖核酸酶降解，并有助于提高它们在受体细胞中的生物学效率。越来越多的证据报道了外泌体在免疫性疾病中的应用前景，并将外泌体视为IDD的潜在治疗来源。本综述重点阐述基于不同细胞来源的外泌体的新型疗法以及外泌体在调节IDD中的重要作用，尤其是免疫策略。
