Targeting osteoarthritis with small extracellular vesicle therapy: potential and perspectives

Area of Science:

• Biomedical Engineering
• Regenerative Medicine
• Orthopedics

Background:

• Osteoarthritis (OA) is a degenerative joint disease characterized by inflammation, cartilage loss, and pain, significantly impacting patient quality of life.
• Extracellular vesicles (EVs), particularly small extracellular vesicles (sEVs), are emerging as a promising therapeutic avenue for OA.
• sEVs, derived from various cell types like mesenchymal stem cells (MSCs), possess anti-inflammatory and regenerative properties beneficial for OA treatment.

Purpose of the Study:

• To systematically review the therapeutic and biomarker potential of sEVs in osteoarthritis (OA) based on literature published between 2019 and 2025.
• To analyze the progress and limitations in sEV-based OA research and understand OA pathogenesis.

Main Methods:

• Systematic literature review of publications from 2019 to 2025 focusing on sEVs and OA.
• Analysis of studies investigating sEV therapeutic applications, mechanisms of action, and biomarker potential in OA.
• Evaluation of research progress in understanding OA pathophysiology in relation to sEV research.

Main Results:

• sEVs demonstrate significant anti-inflammatory and regenerative capabilities, modulating the joint microenvironment to promote chondrogenesis and reduce pain.
• Preclinical and early clinical data suggest sEV therapies can potentially slow OA progression and enhance cartilage repair.
• Despite therapeutic advancements, the fundamental understanding of OA pathogenesis has seen limited change, with research focusing on established mechanisms.

Conclusions:

• sEV-based therapies represent a promising, albeit evolving, approach for OA treatment, with potential to slow disease progression and improve cartilage repair.
• Standardization of sEV isolation, elucidation of mechanisms, and regulatory navigation are key challenges that need addressing.
• Further research is crucial to optimize therapeutic protocols and confirm the clinical efficacy of sEVs for osteoarthritis management.