Potential and Mechanisms of Mesenchymal Stem Cell-Derived Extracellular Vesicles in the Treatment of Osteoarthritis

Chenrui Liu; Haoran Yang

doi:10.54097/n4syh248

Authors

Chenrui Liu
Haoran Yang

DOI:

https://doi.org/10.54097/n4syh248

Keywords:

Osteoarthritis, Mesenchymal Stem Cells, Extracellular Vesicles, Inflammatory Regulation, Cell-free Therapy

Abstract

Osteoarthritis (OA) is a common degenerative joint disease. Current therapeutic strategies mainly focus on symptom relief and are still unable to effectively halt disease progression. Mesenchymal stem cells (MSCs) possess immunomodulatory, anti-inflammatory, and tissue-repair capacities; however, direct cell transplantation remains limited by insufficient stability during in vitro expansion, potential safety risks, and difficulties in quality control. Recent studies have shown that MSC-derived extracellular vesicles (MSC-EVs) can carry bioactive components, including proteins, lipids, mRNA, and miRNA, participate in intercellular communication, and exhibit promising therapeutic potential in OA. Compared with MSCs, MSC-EVs have advantages such as lower immunogenicity, easier storage, and greater suitability for engineering modification. This review summarizes the major mechanisms by which MSC-EVs may contribute to OA treatment, including regulation of inflammation and the synovial microenvironment, promotion of cartilage repair, modulation of immune responses, delay of chondrocyte senescence, and alleviation of pain. In addition, strategies such as surface-targeting modification, miRNA overexpression, hypoxic preconditioning, and low-intensity pulsed ultrasound are discussed for their potential to enhance the therapeutic efficacy of MSC-EVs. Although MSC-EVs show favorable prospects in OA treatment, their key bioactive components, quality standards, large-scale production, and clinical safety require further clarification.

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