Kasula Varun, Padala Vikram, Gupta Nithin, Doyle David, Bagheri Kian, Anastasio Albert, Adams Samuel Bruce
Department of Orthopedic Surgery, Campbell University School of Osteopathic Medicine, Lillington, NC 27546, USA.
Department of Orthopedic Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA.
Biomedicines. 2024 Apr 23;12(5):942. doi: 10.3390/biomedicines12050942.
Achilles tendon (AT) pathologies are common musculoskeletal conditions that can significantly impair function. Despite various traditional treatments, recovery is often slow and may not restore full functionality. The use of extracellular vesicles (EVs) has emerged as a promising therapeutic option due to their role in cell signaling and tissue regeneration. This systematic review aims to consolidate current in vivo animal study findings on the therapeutic effects of EVs on AT injuries. An extensive literature search was conducted using the PubMed, Scopus, and Embase databases for in vivo animal studies examining the effects of EVs on AT pathologies. The extracted variables included but were not limited to the study design, type of EVs used, administration methods, efficacy of treatment, and proposed therapeutic mechanisms. After screening, 18 studies comprising 800 subjects were included. All but one study reported that EVs augmented wound healing processes in the AT. The most proposed mechanisms through which this occurred were gene regulation of the extracellular matrix (ECM), the enhancement of macrophage polarization, and the delivery of therapeutic microRNAs to the injury site. Further research is warranted to not only explore the therapeutic potential of EVs in the context of AT pathologies, but also to establish protocols for their clinical application.
跟腱（AT）病变是常见的肌肉骨骼疾病，会显著损害功能。尽管有各种传统治疗方法，但恢复通常缓慢，可能无法恢复全部功能。由于细胞外囊泡（EVs）在细胞信号传导和组织再生中的作用，其应用已成为一种有前景的治疗选择。本系统评价旨在整合目前关于EVs对AT损伤治疗效果的体内动物研究结果。通过PubMed、Scopus和Embase数据库进行了广泛的文献检索，以查找关于EVs对AT病变影响的体内动物研究。提取的变量包括但不限于研究设计、所用EVs的类型、给药方法、治疗效果以及提出的治疗机制。筛选后，纳入了18项研究，共800名受试者。除一项研究外，所有研究均报告EVs促进了AT的伤口愈合过程。发生这种情况最常见的机制是细胞外基质（ECM）的基因调控、巨噬细胞极化的增强以及治疗性微小RNA向损伤部位的递送。不仅有必要进一步研究EVs在AT病变方面的治疗潜力，还需制定其临床应用方案。
