The Role of Stem Cell-Derived Exosomes in Articular Cartilage Regeneration in Osteoarthritis
DOI:
https://doi.org/10.5281/zenodo.20467099Keywords:
osteoarthritis, exosomes, stem cells, cartilage regeneration, regenerative medicineAbstract
Osteoarthritis is a degenerative joint disease characterized by progressive cartilage degradation, chronic inflammation, and functional impairment, representing one of the leading causes of pain and disability worldwide. Given the limitations of conventional treatments, new regenerative medicine approaches have been investigated, with stem cell-derived exosomes standing out due to their therapeutic potential and ability to promote tissue repair. The present study aimed to analyze the scientific evidence regarding the role of stem cell-derived exosomes in articular cartilage regeneration in osteoarthritis. This is a narrative literature review conducted through searches in the PubMed, Scopus, Web of Science, and Google Scholar databases. Scientific articles published in recent years addressing biological mechanisms, therapeutic applications, and future perspectives related to the use of exosomes in osteoarthritis were included. The analyzed studies demonstrated that exosomes act as important mediators of intercellular communication, transporting proteins, growth factors, lipids, and microRNAs capable of modulating inflammatory processes, reducing chondrocyte apoptosis, and stimulating extracellular matrix synthesis. Furthermore, they play a significant role in regulating signaling pathways associated with cartilage regeneration, including PI3K/Akt, TGF-β/Smad, Wnt/β-catenin, and NF-κB. Emerging strategies involving biomaterials, hydrogels, three-dimensional bioprinting, and controlled-release systems have expanded the clinical potential of this therapy. It is concluded that stem cell-derived exosomes represent a promising alternative for the treatment of osteoarthritis, presenting regenerative, anti-inflammatory, and immunomodulatory effects. However, robust clinical studies are still needed to standardize therapeutic protocols and confirm their efficacy and safety in humans.
References
1. Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. Osteoarthritis: New Insight on Its Pathophysiology. J Clin Med. 2022;11(20):6013. doi:10.3390/jcm11206013.
2. Chen T, Chen W, Xu T, Wang H, Zhang Y, Wang L, Zhu S, Tao H, Yang X. Osteoarthritis: Epidemiology, Pathogenesis, and Treatment. MedComm (2020). 2026;7:e70727. doi:10.1002/mco2.70727.
3. Shtroblia V, Petakh P, Kamyshna I, Halabitska I, Kamyshnyi O. Recent advances in the management of knee osteoarthritis: a narrative review. Front Med (Lausanne). 2025;12:1523027. doi:10.3389/fmed.2025.1523027.
4. Maleitzke T, Elazaly H, Festbaum C, Eder C, Karczewski D, Perka C, Duda GN, Winkler T. Mesenchymal Stromal Cell-Based Therapy—An Alternative to Arthroplasty for the Treatment of Osteoarthritis? A State of the Art Review of Clinical Trials. J Clin Med. 2020;9(7):2062. doi:10.3390/jcm9072062.
5. Lin Y, Anderson JD, Rahnama LMA, Gu SV, Knowlton AA. Exosomes in disease and regeneration: biological functions, diagnostics, and beneficial effects. Am J Physiol Heart Circ Physiol. 2020;319(6):H1162-H1180. doi:10.1152/ajpheart.00075.2020.
6. Aziziyan F, Asl SS, Mahdipour M, Fard RN, Sheykhhasan M. Mesenchymal stem cell-derived extracellular vesicles in musculoskeletal regeneration: mechanisms, applications, and future prospects. Stem Cell Res Ther. 2026;17(1):66. doi:10.1186/s13287-025-04879-1.
7. Qiu L, Alhaskawi A, Moqbel SAA. Osteoarthritis: multitissue pathology, molecular mechanisms, clinical management, and emerging precision and regenerative therapies. Front Pharmacol. 2026;16:1697192. doi:10.3389/fphar.2025.1697192.
8. Rau CS, Kuo PJ, Hsieh CH. Adipose-derived stem cell exosomes: multifaceted therapeutic applications in regenerative medicine. Int J Surg. 2025;111(10):7099-7113. doi:10.1097/JS9.0000000000002841.
9. Shimizu Y, Inoue Y, Matsuura N, Ishii T, Sowa Y, Sunami H, Ntege EH. Mesenchymal stromal cell-derived extracellular vesicles in regenerative medicine: Standardisation, bioengineering and clinical translation. Regen Ther. 2025;31:101058. doi:10.1016/j.reth.2025.101058.
10. Wu Y, Li J, Zeng Y, Pu W, Mu X, Sun K, Peng Y, Shen B. Exosomes rewire the cartilage microenvironment in osteoarthritis: from intercellular communication to therapeutic strategies. Int J Oral Sci. 2022;14(1):40. doi:10.1038/s41368-022-00187-z.
11. Kong H, Zheng J, Han J, et al. The crosstalk among macrophages, chondrocytes and mesenchymal stem cells in osteoarthritis: the role of extracellular vesicles. Stem Cell Res Ther. 2025;16:553. doi:10.1186/s13287-025-04659-x.
12. Tembo KM, Wang X, Bolideei M, Liu Q, Baboni F, Mehran MJ, Sun F, Wang CY. Exploring the bioactivity of MicroRNAs Originated from Plant-derived Exosome-like Nanoparticles (PELNs): current perspectives. J Nanobiotechnology. 2025;23(1):563. doi:10.1186/s12951-025-03602-9.
13. Pakdaman Kolour SS, Nematollahi S, Dehbozorgi M, Fattahi F, Movahed F, Esfandiari N, Kahrizi MS, Ghavamikia N, Salmanian Hajiagha B. Extracellular vesicles (EVs) microRNAs (miRNAs) derived from mesenchymal stem cells (MSCs) in osteoarthritis (OA): detailed role in pathogenesis and possible therapeutics. Heliyon. 2025;11(3):e42258.
14. Banu SA, Sharun K, Emmanuel RS, Mamachan M, Manjusha KM, Muthu S, El-Husseiny HM, Kumar R, Pawde AM, Dhama K, Amarpal. Stem Cell Exosomes for Osteoarthritis in Veterinary Medicine. Stem Cells Int. 2025;2025:4888569. doi:10.1155/sci/4888569.
15. Liu Z, Zhuang Y, Fang L, Yuan C, Wang X, Lin K. Breakthrough of extracellular vesicles in pathogenesis, diagnosis and treatment of osteoarthritis. Bioact Mater. 2023;22:423-452. doi:10.1016/j.bioactmat.2022.10.012.
16. Serrano DR, Juste F, Anaya BJ, Ramirez BI, Sánchez-Guirales SA, Quispillo JM, Hernandez EM, Simon JA, Trallero JM, Serrano C, Rawat S, Lalatsa A. Exosome-Based Drug Delivery: A Next-Generation Platform for Cancer, Infection, Neurological and Immunological Diseases, Gene Therapy and Regenerative Medicine. Pharmaceutics. 2025;17(10):1336. doi:10.3390/pharmaceutics17101336.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Angelina da Costa Moreno
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os artigos publicados na International Journal of Health and Surgical Research são licenciados sob a Creative Commons Attribution 4.0 International (CC BY 4.0).
Isso permite que outros distribuam, remixem, adaptem e criem a partir do trabalho publicado, para qualquer finalidade, incluindo comercial, desde que seja dado o devido crédito ao autor original e à revista.
Os autores mantêm os direitos autorais de seus trabalhos e concedem à revista o direito de primeira publicação.
