National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin 632007, Taiwan.
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
Int J Mol Sci. 2024 Aug 23;25(17):9149. doi: 10.3390/ijms25179149.
Osteoarthritis (OA) is a leading cause of pain and disability worldwide in elderly people. There is a critical need to develop novel therapeutic strategies that can effectively manage pain and disability to improve the quality of life for older people. Mesenchymal stem cells (MSCs) have emerged as a promising cell-based therapy for age-related disorders due to their multilineage differentiation and strong paracrine effects. Notably, MSC-derived exosomes (MSC-Exos) have gained significant attention because they can recapitulate MSCs into therapeutic benefits without causing any associated risks compared with direct cell transplantation. These exosomes help in the transport of bioactive molecules such as proteins, lipids, and nucleic acids, which can influence various cellular processes related to tissue repair, regeneration, and immune regulation. In this review, we have provided an overview of MSC-Exos as a considerable treatment option for osteoarthritis. This review will go over the underlying mechanisms by which MSC-Exos may alleviate the pathological hallmarks of OA, such as cartilage degradation, synovial inflammation, and subchondral bone changes. Furthermore, we have summarized the current preclinical evidence and highlighted promising results from in vitro and in vivo studies, as well as progress in clinical trials using MSC-Exos to treat OA.
骨关节炎（OA）是全球老年人疼痛和残疾的主要原因。因此，迫切需要开发新的治疗策略，以有效缓解疼痛和残疾，提高老年人的生活质量。间充质干细胞（MSCs）由于其多向分化和强大的旁分泌作用，已成为与年龄相关疾病的一种有前途的细胞治疗方法。值得注意的是，MSC 来源的外泌体（MSC-Exos）引起了广泛关注，因为与直接细胞移植相比，它们可以复制 MSC 的治疗效果，而不会带来任何相关风险。这些外泌体有助于生物活性分子（如蛋白质、脂质和核酸）的运输，从而影响与组织修复、再生和免疫调节相关的各种细胞过程。在本综述中，我们概述了 MSC-Exos 作为治疗骨关节炎的一种可行选择。本综述将讨论 MSC-Exos 缓解 OA 病理特征（如软骨降解、滑膜炎症和软骨下骨变化）的潜在机制。此外，我们还总结了目前的临床前证据，并强调了来自体外和体内研究以及使用 MSC-Exos 治疗 OA 的临床试验的有希望的结果。
