Small extracellular vesicles in osteoarthritis: A double‑edged sword regulating inflammation and cartilage...

Osteoarthritis (OA) is a progressive degenerative joint disease and a leading cause of pain, disability and loss of joint function in older adults worldwide. Small extracellular vesicles (sEVs) are small vesicles secreted by cells and found in various body fluids. They carry a range of bioactive molecules, including nucleic acids, proteins and lipids, and participate in numerous cellular physiological activities, such as cell death, inflammation, immunity, proliferation, migration and differentiation. Depending on their cellular origin, sEVs can exert opposing effects on OA: They may either aggravate inflammation and cartilage damage or suppress inflammation and promote cartilage repair. Therefore, this review focuses on the preclinical research evidence regarding the dual mechanism of 'promoting or treating' by sEVs in the disease of OA, aiming to construct a theoretical framework to provide a theoretical basis for the development and translational application of OA treatment strategies based on sEVs.