Longfei Han, Wenyuan Hou, Weihua Fang, Peng Peng, Sun Lu, Kun Lin, Mincong He, Fan Yang, Wei He, Qiushi Wei
Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Traumatology and Orthopedics Institute of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Front Cell Dev Biol. 2025 Mar 5;13:1460416. doi: 10.3389/fcell.2025.1460416. eCollection 2025.
Osteoarthritis (OA) is a debilitating disease that predominantly impacts the hip, hand, and knee joints. Its pathology is defined by the progressive degradation of articular cartilage, formation of bone spurs, and synovial inflammation, resulting in pain, joint function limitations, and substantial societal and familial burdens. Current treatment strategies primarily target pain alleviation, yet improved interventions addressing the underlying disease pathology are scarce. Recently, exosomes have emerged as a subject of growing interest in OA therapy. Numerous studies have investigated exosomes to offer promising therapeutic approaches for OA through diverse and models, elucidating the mechanisms by which exosomes from various cell sources modulate the cartilage microenvironment and promote cartilage repair. Preclinical investigations have demonstrated the regulatory effects of exosomes originating from human cells, including mesenchymal stem cells (MSC), synovial fibroblasts, chondrocytes, macrophages, and exosomes derived from Chinese herbal medicines, on the modulation of the cartilage microenvironment and cartilage repair through diverse signaling pathways. Additionally, therapeutic mechanisms encompass cartilage inflammation, degradation of the cartilage matrix, proliferation and migration of chondrocytes, autophagy, apoptosis, and mitigation of oxidative stress. An increasing number of exosome carrier scaffolds are under development. Our review adopts a multidimensional approach to enhance comprehension of the pivotal therapeutic functions exerted by exosomes sourced from diverse cell types in OA. Ultimately, our aim is to pinpoint therapeutic targets capable of regulating the cartilage microenvironment and facilitating cartilage repair in OA.
骨关节炎（OA）是一种使人衰弱的疾病，主要影响髋关节、手部关节和膝关节。其病理特征为关节软骨的渐进性退化、骨赘形成和滑膜炎症，导致疼痛、关节功能受限，并带来巨大的社会和家庭负担。目前的治疗策略主要针对缓解疼痛，但针对潜在疾病病理的改进干预措施却很少。最近，外泌体已成为骨关节炎治疗中越来越受关注的主题。许多研究通过多种细胞类型和模型对外泌体进行了研究，为骨关节炎提供了有前景的治疗方法，阐明了来自各种细胞来源的外泌体调节软骨微环境和促进软骨修复的机制。临床前研究已经证明，源自人类细胞（包括间充质干细胞（MSC）、滑膜成纤维细胞、软骨细胞、巨噬细胞）的外泌体以及源自中药的外泌体，通过多种信号通路对软骨微环境的调节和软骨修复具有调节作用。此外，治疗机制包括软骨炎症、软骨基质降解、软骨细胞增殖和迁移、自噬、凋亡以及氧化应激的减轻。越来越多的外泌体载体支架正在研发中。我们的综述采用多维度方法，以增强对源自不同细胞类型的外泌体在骨关节炎中发挥的关键治疗功能的理解。最终，我们的目标是确定能够调节骨关节炎软骨微环境并促进软骨修复的治疗靶点。
