Breakthrough of extracellular vesicles in pathogenesis, diagnosis and treatment of osteoarthritis

Bioactive Materials, 2023 · DOI: https://doi.org/10.1016/j.bioactmat.2022.10.012 · Published: January 1, 2023

Genetics Orthopedics Regenerative Medicine & Stem Cells

Simple Explanation

Osteoarthritis (OA) is a widespread joint disease causing pain and disability, lacking effective early diagnosis and treatment. Stem cell therapy faces issues like immune rejection and tumorigenicity. Extracellular vesicles (EVs) facilitate intercellular communication by transmitting genetic information, acting as paracrine factors of stem cells. They play a crucial role in OA's pathogenesis, diagnosis, and treatment. This review discusses EVs' influence on inflammation, metabolism, and aging in OA progression. It also explores EVs from blood, synovial fluid, and joint-related cells for diagnosis and modified/unmodified EVs for OA therapy.

Study Duration

Not specified

Participants

114 patients with OA and healthy controls

Evidence Level

Review article

Key Findings

1
EVs play a significant role in OA pathogenesis by influencing inflammation, metabolism, and cellular senescence within joint tissues.
2
EVs can be utilized as biomarkers for OA diagnosis, providing information about disease stages, subtypes, and potential therapeutic efficacy.
3
Both unmodified and modified EVs have shown therapeutic potential in OA treatment, with ongoing research exploring strategies to enhance their delivery, targeting, and release using biomaterials.

Research Summary

This review provides an overview of the role of EVs in OA, focusing on the pathogenesis, diagnosis, and treatment, while considering the associated challenges and limitations. The review summarizes the role of EVs in OA progression by influencing inflammation, metabolism, and aging; EVs from blood, synovial fluid, and joint-related cells used for diagnosis and differential diagnosis. Therapeutic values of modified and unmodified EVs for treating OA and biomaterial-loaded EVs for release control are explored. An outlook for the future development of EVs in the arthrosis fields is provided.

Practical Implications

Diagnostic Biomarkers

EVs can be explored as biomarkers for early diagnosis, disease stage identification, and therapeutic monitoring in OA.

Therapeutic Interventions

EVs, both modified and unmodified, represent potential cell-free therapeutic strategies for OA, offering benefits over traditional stem cell therapies.

Targeted Drug Delivery

Engineered EVs, combined with biomaterials, can improve targeted drug delivery and sustained release in the joint, enhancing therapeutic outcomes.

Study Limitations

1
Lack of standardization in EVs nomenclature and isolation techniques.
2
Limited number of studies on susceptibility to OA and the role of EVs in phenotypes.
3
Challenges in clinical translation due to the complexity of OA pathogenesis and joint structure.

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