Chen Junjie, Wang Zihe, Yi Ming, Yang Yi, Tian Mengzhao, Liu Yinqi, Wang Guoyou, Shen Huarui
Department of Joint Surgery, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan, China.
School of Materials and Energy, Southwest University, Southwest University Hospital, Chongqing, China.
J Transl Med. 2025 Jan 12;23(1):47. doi: 10.1186/s12967-024-06029-2.
Rotator cuff injury (RCI), characterized by shoulder pain and restricted mobility, represents a subset of tendon-bone insertion injuries (TBI). In the majority of cases, surgical reconstruction of the affected tendons or ligaments is required to address the damage. However, numerous clinical failures have underscored the suboptimal outcomes associated with such procedures. Further investigations have revealed that these failures are largely attributable to delayed healing at the tendon-bone interface, excessive formation of vascularized scar tissue, and inadequate integration of tendon grafts within bone tunnels. As a result, the healing process of rotator cuff injuries faces significant challenges.Bone marrow-derived mesenchymal stem cell exosomes (BMSC-exos) have emerged as a prominent focus of research within the field of bioengineering, owing to their remarkable potential to regulate cellular proliferation and differentiation, modulate immune responses, and facilitate tissue repair and regeneration following cellular damage. In this review, we explore the anti-inflammatory, angiogenic, anti-scarring, and bone metabolism-modulating effects of BMSC-exos in the context of rotator cuff injury. Additionally, we address the limitations and ongoing challenges within current research, offering insights that could guide the clinical application of BMSC-exos in the treatment of rotator cuff injuries in the future.
肩袖损伤（RCI）以肩部疼痛和活动受限为特征，是肌腱-骨插入伤（TBI）的一种。在大多数情况下，需要对受影响的肌腱或韧带进行手术重建以解决损伤问题。然而，大量临床失败案例凸显了此类手术效果欠佳的情况。进一步研究表明，这些失败在很大程度上归因于肌腱-骨界面愈合延迟、血管化瘢痕组织过度形成以及肌腱移植物在骨隧道内整合不足。因此，肩袖损伤的愈合过程面临重大挑战。骨髓间充质干细胞外泌体（BMSC-exos）因其在调节细胞增殖和分化、调节免疫反应以及促进细胞损伤后组织修复和再生方面的显著潜力，已成为生物工程领域的一个突出研究重点。在本综述中，我们探讨了BMSC-exos在肩袖损伤背景下的抗炎、促血管生成、抗瘢痕形成和调节骨代谢的作用。此外，我们阐述了当前研究中的局限性和持续存在的挑战，提供了有助于指导未来BMSC-exos在肩袖损伤治疗中临床应用的见解。
