“…More recently, MSCs-EV have been shown to mediate the therapeutic effects of MSCs in various diseases and have been applied to clinical trials for several diseases, such as type I diabetes mellitus (trial NCT02138331), macular holes (NCT03437759) and acute ischemic stroke (NCT03384433) 4 . Thus, the role of MSCs-EV in the treatment of bone diseases has Inhibit T lymphocyte proliferation, stimulate macrophage polarization toward anti-inflammatory phenotype, restore mitochondrial function and oxidative stress damage, balance the energy metabolism, suppress mitochondrial dysfunction apoptosis of chondrocytes through inhibiting the phosphorylation of p38 and ERK1/2 c , and stimulating of the phosphorylation of AKT d signaling pathway, which promote cartilage regeneration Chen et al, 2016Chen et al, , 2019Cosenza et al, 2017Cosenza et al, , 2018Mao et al, 2018;Qi et al, 2019 AD a Bone marrow mesenchymal stem cells; b Osteoarthritis; c Extracellular regulated protein kinases; d Phosphorylation of protein-serine-threonine kinase; e Adipose tissuederived mesenchymal stem cells; f Interleukin-1β; g Human embryonic-derived mesenchymal stem cells; h Adenosine 5 -monophosphate (AMP)-activated protein kinase; i Sulfated glycosaminoglycan; j Infrapatellar fat pad (IPFP)-derived mesenchymal stem cells; k Mammalian target of rapamycin; l Synovial mesenchymal stem cells; m Yes-associated protein; n Extracellular matrix; o Rheumatoid arthritis; p Matrix metalloproteinase 14; q Vascular endothelial growth factor; r Human-induced pluripotent mesenchymal stem cells; s Osteoporosis; t Mitogen-activated protein kinase; u DNA methyltransferase1; v Runt-related transcription factor 2; w Alkaline phosphatase;…”