Mesenchymal Stem Cell-Derived Extracellular Vesicles for Osteoarthritis Treatment: Extracellular Matrix Protection, Chondrocyte and Osteocyte Physiology, Pain and Inflammation Management

Abstract

Osteoarthritis (OA) is a prevalent degenerative disease characterized by persistent pain and restricted motion. In recent years, mesenchymal stem cells (MSCs) have emerged as a promising alternative therapy for OA due to their regenerative potential. A significant component of MSC-based therapies is the trophic factors contained within extracellular vesicles (EVs), including exosomes. These EVs have shown potential in mitigating the OA phenotype by targeting various biological processes linked to cartilage extracellular matrix (ECM) degradation and offering protective effects to various joint cell types.

Despite these advancements, the efficacy of EV treatment for OA can vary, influenced by factors such as the EV cargo, source of MSCs, and the specific pathological context. This review aims to synthesize and evaluate the effects of MSC-derived EVs across different stages of OA, focusing on their impact on cartilage ECM, chondrocyte function, osteocyte and bone homeostasis, inflammation, and pain management. Additionally, we discuss strategies and recent technological advancements for enhancing the specificity and effectiveness of EV-based therapies for OA, bringing these approaches closer to clinical application.