Efficacy of Extracellular Vesicles From Mesenchymal Stem Cells on Osteoarthritis in Animal Models: A Systematic Review and Meta-Analysis

Abstract

Background: Some studies have reported results from the use of mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) to treat osteoarthritis (OA). Objective: To evaluate the efficacy of MSC-EVs as a treatment for OA. Data sources: Databases were searched using the terms ‘mesenchymal stem cells’, ‘osteoarthritis’ and ‘extracellular vesicles.’ Study eligibility criteria: Studies performed in animal models utilizing MSC-EVs to treat OA that described the macroscopic evaluation or histological evaluation were included. Study appraisal: The quality of the studies was examined using the CAMARADES quality checklist. Results: MSC-EVs were superior to the placebo in the macroscopic evaluation and histological evaluation. MSC-EVs were more effective in the early stage of OA and once a week was better than multiple times a week. Limitations: The included studies were highly heterogeneous. Conclusion: MSC-EVs may improve the results of macroscopic and histological evaluations of OA.

The Application of Extracellular Vesicles Mediated miRNAs in Osteoarthritis: Current Knowledge and Perspective

“…Although almost all the cells could secrete EVs, previous studies focused on MSCs derived from various tissues such as bone marrow, adipose tissue, umbilical cord, and embryonic tissue. 19 However, although these MSCs secreted EVs shared similar therapeutic mechanisms by promoting proliferation, regeneration, and anti-inflammation, they demonstrate tissue specificity to treat some diseases, including OA. For example, EVs derived from BMSCs have been chiefly studied to treat disorders related to bone, such as cartilage defects or OA.…”

“… 18 Especially, numerous studies have researched the role of EVs-mediated miRNAs regulation in the progress of OA and demonstrated encouraging results. 19–21 However, most studies neglected the details of EVs’ quantification in the published papers when utilizing EVs as a transport agent of miRNAs directly to evaluate relevant function in the treatment of OA. For example, the information about the ratio of EVs and treated cells in vitro and the amount of EVs injected into the joint per time in vivo were sometimes lacking or vaguely described, which is hard for other laboratories to repeat a similar experiment and make interlaboratory comparisons of experimental results unwarrantable Meanwhile, differentiated quantitative management of EVs-miRNAs among studies, which could affect the standardization of its application, also impede the clinical transformation of EVs.…”

Pooled Analysis of Mesenchymal Stromal Cell-Derived Extracellular Vesicle Therapy for Liver Disease in Preclinical Models

“…The role of MSC-derived extracellular vesicles (EV) in tissue repair and regeneration has been studied in several tissues, including the heart, lung, bone, skin, brain, kidney, and liver [ 8 , 9 ]. Meta-analyses of preclinical trials have shown that exosomes can be beneficial for myocardial infarction [ 10 ], acute and chronic respiratory diseases [ 11 ], acute kidney injury [ 12 ], and osteoarthritis [ 13 ]. Li et al (2013).…”

Hypoxia-Preconditioned Extracellular Vesicles from Mesenchymal Stem Cells Improve Cartilage Repair in Osteoarthritis

“…In recent years, emerging research on the transplantation of MSC-EVs to treat OA has obtained good results. Therefore, MSC-EVs are considered ideal substitutes for MSCs as a cell-free OA treatment [7].…”