Osteoarthritis (OA) progression is highly associated
with chondrocyte
mitochondrial dysfunction and disorders of catabolism and anabolism
of the extracellular matrix (ECM) in the articular cartilage. The
mitochondrial unfolded protein response (UPRmt), which
is an integral component of the mitochondrial quality control (MQC)
system, is essential for maintaining chondrocyte homeostasis. We successfully
validated the pivotal role of activating transcription factor 5 (ATF5)
in upregulating the UPRmt, mitigating IL-1β-induced
inflammation and mitochondrial dysfunction, and promoting balanced
metabolism in articular cartilage ECM, proving its potential as a
promising therapeutic target for OA. Modified mRNAs (modRNAs) have
emerged as novel and efficient gene delivery vectors for nucleic acid
therapeutic approaches. In this study, we combined Atf5-modRNA (modAtf5)
with engineered exosomes derived from bone mesenchymal stem cells
(ExmodAtf5) to exert cytoprotective effects on chondrocytes
in articular cartilage via Atf5. However, the rapid localized metabolization
of ExmodAtf5 limits its application. PLGA–PEG-PLGA
(Gel), an injectable thermosensitive hydrogel, was used as a carrier
of ExmodAtf5 (Gel@ExmodAtf5) to achieve a sustained
release of ExmodAtf5. In vitro and in vivo, the use of Gel@ExmodAtf5 was shown to
be a highly effective strategy for OA treatment. The in vivo therapeutic effect of Gel@ExmodAtf5 was evidenced by
the preservation of the intact cartilage surface, low OARSI scores,
fewer osteophytes, and mild subchondral bone sclerosis and cystic
degeneration. Consequently, the combination of ExmodAtf5 and PLGA–PEG-PLGA could significantly enhance the therapeutic
efficacy and prolong the exosome release. In addition, the mitochondrial
protease ClpP enhanced chondrocyte autophagy by modulating the mTOR/Ulk1
pathway. As a result of our research, Gel@ExmodAtf5 can
be considered to be effective at alleviating the progression of OA.