Mesenchymal Stem Cell-Derived Exosomes and Intervertebral Disc Regeneration: Review

Abstract

Intervertebral disc degeneration (IVDD) is a common cause of lower back pain (LBP), which burdens individuals and society as a whole. IVDD occurs as a result of aging, mechanical trauma, lifestyle factors, and certain genetic abnormalities, leads to loss of nucleus pulposus, alteration in the composition of the extracellular matrix, excessive oxidative stress, and inflammation in the intervertebral disc. Pharmacological and surgical interventions are considered a boon for the treatment of IVDD, but the effectiveness of those strategies is limited. Mesenchymal stem cells (MSCs) have recently emerged as a possible promising regenerative therapy for IVDD due to their paracrine effect, restoration of the degenerated cells, and capacity for differentiation into disc cells. Recent investigations have shown that the pleiotropic effect of MSCs is not related to differentiation capacity but is mediated by the secretion of soluble paracrine factors. Early studies have demonstrated that MSC-derived exosomes have therapeutic potential for treating IVDD by promoting cell proliferation, tissue regeneration, modulation of the inflammatory response, and reduced apoptosis. This paper highlights the current state of MSC-derived exosomes in the field of treatment of IVDD with further possible future developments, applications, and challenges.

Ferroptosis: A potential target for the intervention of intervertebral disc degeneration

“…EVs, exosomes, and ncRNAs are involved in the regulation of gene expression related to ferroptosis, which has emerged as a potential therapeutic strategy for IVDD ( 116 , 145 , 146 ). The upregulation of miR-10a-5p inhibited IL-6R expression, thereby partially reducing IL-6-induced ferroptosis in chondrocytes ( 45 ).…”

The Influence of Intervertebral Disc Microenvironment on the Biological Behavior of Engrafted Mesenchymal Stem Cells

“…Compared with other cell types, MSCs can produce more exosomes through the paracrine pathway [57]. The results have shown that MSC-Exos can delay or even reverse the degenerative process of IVD by maintaining ECM homeostasis, inhibiting apoptosis of NP cells, antioxidative, and anti-inflammatory effects, although the exact underlying mechanisms have not been fully elucidated [58][59][60][61]. MSCderived exosomes (MSC-Exos) have unique advantages in the treatment of IDD when compared with MSCs.…”

Concepts of Regeneration for Spinal Diseases in 2022

“…Bhujel B et al [ 8 ] explored whether pleiotropic effects of MSCs would be related to the differentiation capacity or mediated by the secretion of soluble paracrine factors, MSC-derived exosomes. Their extensive literature search and review clarified diverse prospects of MSC-derived exosomes to repair degenerative discs.…”