Yang Hongwei, Yang Haochen, Wang Qin, Ji Hanzhen, Qian Tianmei, Qiao Yusen, Shi Junfeng, Cong Meng
Department of Orthopedics, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China.
Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education and Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China.
Front Bioeng Biotechnol. 2025 Apr 24;13:1591400. doi: 10.3389/fbioe.2025.1591400. eCollection 2025.
Cartilage is crucial for joints, and its damage can lead to pain and functional impairment, causing financial burden to patients. Due to its weak self-repair, cartilage injury control is a research focus. Cartilage injury naturally with age, but mechanical trauma, lifestyle factors and certain genetic abnormalities can increase the likelihood of symptomatic disease progression. Current treatments for cartilage injury include pharmacological and surgical interventions, but these lack the ability to stop the progression of disease and restore the regeneration of the cartilage. Biological therapies have been evaluated but show varying degrees of efficacy in cartilage regeneration long-term. The mesenchymal stem cell (MSC) therapy attracts attention as it is easily harvested and expanded. Once thought to repair via differentiation, MSCs are now known to secrete extracellular vesicles (EVs) paracrinely. These EVs, rich in bioactive molecules, enable cell communication, boost growth factor secretion, regulate the synthesis and degradation of extracellular matrix (ECM), and modulate inflammation, vital for cartilage repair. However, further research and clinical validation are still required for the application of MSC and MSC-EVs. This review highlights the current state of research on the use of MSC and MSC-EVs in the treatment of cartilage injury. It is hoped that the review in this paper will provide valuable references and inspiration for future researchers in therapeutic studies of cartilage repair.
软骨对关节至关重要，其损伤会导致疼痛和功能障碍，给患者带来经济负担。由于软骨自身修复能力较弱，控制软骨损伤是一个研究重点。软骨损伤会自然随年龄增长而出现，但机械创伤、生活方式因素和某些基因异常会增加症状性疾病进展的可能性。目前针对软骨损伤的治疗方法包括药物和手术干预，但这些方法缺乏阻止疾病进展和恢复软骨再生的能力。生物疗法已得到评估，但在长期软骨再生方面显示出不同程度的疗效。间充质干细胞（MSC）疗法因其易于获取和扩增而受到关注。MSC 曾经被认为是通过分化进行修复，现在已知其通过旁分泌分泌细胞外囊泡（EVs）。这些富含生物活性分子的 EVs 能够实现细胞间通讯、促进生长因子分泌、调节细胞外基质（ECM）的合成与降解以及调节炎症，这些对软骨修复至关重要。然而，MSC 和 MSC-EVs 的应用仍需要进一步的研究和临床验证。本综述重点介绍了 MSC 和 MSC-EVs 在治疗软骨损伤方面的研究现状。希望本文的综述能为未来软骨修复治疗研究的人员提供有价值的参考和启示。
