In vivo circRNA-engineered macrophages mediate localized MMP9 neutralization to rejuvenate aged bone

Aging causes osteoporosis, delayed fracture repair, and osteoarthritis, but mechanisms and therapies remain unclear. Transcriptomics of serum and bone from older patients showed marked MMP9 upregulation, highlighting systemic MMP9 neutralization as a potential immunotherapy. Here, we developed an in vivo circRNA-based antibody-engineering strategy that specifically targets macrophages, converting them into biofactories for anti-MMP9 antibodies. Central to this therapy is an apoptosis-mimicking lipid nanoparticle incorporating phosphatidylserine with an optimized formulation (aMMP9-LNP), which enhances macrophage-specific recognition and endocytosis. Leveraging inflammation-guided chemotaxis, this approach enables systemic, targeted MMP9 neutralization. In aged mice, systemic aMMP9-LNP reduced stem cell senescence, boosted osteogenesis, accelerated fracture repair, and mitigated cartilage degeneration. Mechanistically, MMP9 blockade dampened senescence-associated secretory phenotype, restored osteoblast-osteoclast balance, and lowered p21/MMP3. Biodistribution confirmed bone-targeted delivery with preserved tissue homeostasis, supporting translational potential. Collectively, our results identify MMP9 as a key effector and advance an in vivo mRNA immunotherapy for skeletal aging.