Tang Ao, Shu Qing, Jia Shaohui, Lai Zhihao, Tian Jun
Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China.
College of Sports Medicine, Wuhan Sports University, Wuhan, People's Republic of China.
Int J Nanomedicine. 2024 Dec 19;19:13547-13562. doi: 10.2147/IJN.S486622. eCollection 2024.
Musculoskeletal disorders are a series of diseases involving bone, muscle, cartilage, and tendon, mainly caused by chronic strain, degenerative changes, and structural damage due to trauma. The disorders limit the function of patients due to pain and significantly reduce their quality of life. In recent years, adipose-derived mesenchymal stem cells have been extensively applied in regeneration medicine research due to their particular abilities of self-renewal, differentiation, and targeted homing and are more easily accessed compared with other sources. The paracrine effect of ADSCs plays a crucial role in intercellular communication by releasing mass mediators, including cytokines and growth factors, particularly the exosomes they secrete. Not only do these exosomes possess low immunogenicity, low toxicity, and an enhanced ability to penetrate a bio-barrier, but they also inherit their parent cells' characteristics and carry various bioactive molecules to release to targeted cells, modulating their biological process. Meanwhile, these characteristics also make exosomes a natural nanocarrier capable of targeted drug delivery to specific sites, enhancing the bioavailability of drugs within the body and achieving precision therapy with fewer toxic side effects. Furthermore, the integration of exosomes with tissue engineering and chemical modification strategies can also significantly enhance their efficacy in facilitating tissue repair. However, the current research on ADSC-Exos for improving MSDs remains at an early stage and needs further exploration. Therefore, this review summarized the ADSC-Exo as a nanodrug carrier characteristics and mechanism in the treatment of fracture, osteoporosis, osteoarthritis, intervertebral disc degeneration, and tendon injury, which push forward the research progress of ADSC-Exo therapy for MSDs.
肌肉骨骼疾病是一系列涉及骨骼、肌肉、软骨和肌腱的疾病，主要由慢性劳损、退行性改变以及创伤导致的结构损伤引起。这些疾病由于疼痛限制了患者的功能，并显著降低了他们的生活质量。近年来，脂肪来源的间充质干细胞因其自我更新、分化和靶向归巢的特殊能力，在再生医学研究中得到了广泛应用，并且与其他来源相比更容易获取。脂肪来源间充质干细胞的旁分泌作用通过释放大量介质（包括细胞因子和生长因子），特别是它们分泌的外泌体，在细胞间通讯中发挥关键作用。这些外泌体不仅具有低免疫原性、低毒性和增强的穿透生物屏障的能力，还继承了其亲本细胞的特性，并携带各种生物活性分子释放到靶向细胞，调节其生物学过程。同时，这些特性也使外泌体成为一种能够将药物靶向递送至特定部位的天然纳米载体，提高体内药物的生物利用度，并以更少的毒副作用实现精准治疗。此外，外泌体与组织工程和化学修饰策略的整合也可以显著提高它们在促进组织修复方面的功效。然而，目前关于脂肪来源间充质干细胞外泌体用于改善肌肉骨骼疾病的研究仍处于早期阶段，需要进一步探索。因此，本综述总结了脂肪来源间充质干细胞外泌体作为纳米药物载体在治疗骨折、骨质疏松症、骨关节炎、椎间盘退变和肌腱损伤方面的特性和机制，推动了脂肪来源间充质干细胞外泌体治疗肌肉骨骼疾病的研究进展。
