Department of Dermatology, Chung‑Ang University College of Medicine, Seoul 06973, Republic of Korea.
CK‑Exogene, Inc., Seongnam, Gyeonggi‑do 13201, Republic of Korea.
Int J Mol Med. 2022 May;49(5). doi: 10.3892/ijmm.2022.5118. Epub 2022 Mar 16.
Osteoarthritis (OA), although extensively researched, still lacks an effective and safe treatment. The only current treatment option available for advanced OA is joint replacement surgery. This surgery may pose the risks of persistent pain, surgical complications and limited implant lifespan. Transforming growth factor (TGF)‑β has a crucial role in multiple cellular processes such as cell proliferation. Any deterioration in TGF‑β signaling pathways can have an immense impact on OA. Owing to the crucial role of TGF‑β in cartilage homeostasis, targeting it could be an alternative therapeutic approach. Additionally, stem cell‑based therapy has recently emerged as an effective treatment strategy that could replace surgery. A number of recent findings suggest that the tissue regeneration effect of stem cells is attributed to the paracrine secretion of anti‑inflammatory and chondroprotective mediators or trophic factors, particularly nanosized extracellular vesicles (i.e., exosomes). Literature searches were performed in the MEDLINE, EMBASE, Cochrane Library and PubMed electronic database for relevant articles published before September 2021. Multiple investigators have confirmed TGF‑β3 as a promising candidate which has the chondrogenic potential to repair articular cartilage degeneration. Combining TGF‑β3 with bone morphogenetic proteins‑6, which has synergistic effect on chondrogenesis, with an efficient platform such as exosomes, which themselves possess a chondroprotective function, offers an innovative and more efficient approach to treat injured cartilage. In addition, multiple findings stating the role of exosomes in chondroprotection has also verified a similar fact showing exosomes may be a more favorable choice than the source itself. In the present review, the importance of TGF‑β family in OA and the possibility of therapeutic treatment using stem cell‑derived exosomes are described.
骨关节炎（OA）虽然研究广泛，但仍缺乏有效和安全的治疗方法。目前针对晚期 OA 的唯一治疗选择是关节置换手术。这种手术可能会带来持续疼痛、手术并发症和植入物寿命有限的风险。转化生长因子（TGF）-β在细胞增殖等多种细胞过程中发挥着关键作用。TGF-β信号通路的任何恶化都可能对 OA 产生巨大影响。由于 TGF-β在软骨稳态中的关键作用，靶向它可能是一种替代的治疗方法。此外，基于干细胞的治疗最近已成为一种有效的治疗策略，可以替代手术。许多新发现表明，干细胞的组织再生作用归因于抗炎和软骨保护介质或营养因子的旁分泌分泌，特别是纳米大小的细胞外囊泡（即外泌体）。在 MEDLINE、EMBASE、Cochrane 图书馆和 PubMed 电子数据库中进行了文献检索，以查找 2021 年 9 月之前发表的相关文章。许多研究人员已经证实 TGF-β3 是一种很有前途的候选物，它具有修复关节软骨退化的软骨形成潜力。将 TGF-β3 与具有协同成软骨作用的骨形态发生蛋白-6 与有效的平台（如具有软骨保护功能的外泌体）结合使用，为治疗受损软骨提供了一种创新且更有效的方法。此外，多项关于外泌体在软骨保护中的作用的发现也验证了一个类似的事实，即外泌体可能是比来源本身更有利的选择。在本综述中，描述了 TGF-β 家族在 OA 中的重要性以及使用干细胞衍生的外泌体进行治疗的可能性。
