The Potential Use of Mesenchymal Stem Cells and Their Derived Exosomes for Orthopedic Diseases Treatment

Abstract

Musculoskeletal disorders (MSDs) are conditions that can affect muscles, bones, and joints. These disorders are very painful and severely limit patients' mobility and are more common in the elderly. MSCs are multipotent stem cells isolated from embryonic (such as the umbilical cord) and mature sources (such as adipose tissue and bone marrow). These cells can differentiate into various cells such as osteoblasts, adipocytes, chondrocytes, NP-like cells, Etc. Due to MSC characteristics such as immunomodulatory properties, ability to migrate to the site of injury, recruitment of cells involved in repair, production of growth factors, and large amount production of extracellular vesicles, these cells have been used in many regenerativerelated medicine studies. Also, MSCs produce different types of EVs, such as exosomes, to the extracellular environment. Exosomes reflect MSCs' characteristics and do not have cell therapy-associated problems because they are cell-free. These vesicles carry proteins, nucleic acids, and lipids to the host cell and change their function. This review focuses on MSCs and MSCs exosomes' role in repairing dense connective tissues such as tendons, cartilage, invertebrate disc, bone fracture, and osteoporosis treatment.

Mesenchymal Stem Cell-Derived Exosomes as a Novel Strategy for the Treatment of Intervertebral Disc Degeneration

“…Exosomes, a subset of extracellular vesicle (EVs), are phospholipid vesicles that are membrane-bound and released by nearly all tissues, cells, and body fluids (plasma, urine, saliva, amniotic fluid, gastrointestinal secretions, semen, synovial fluid, and breast milk) ( Pegtel and Gould, 2019 ). EVs are classified into three categories as follows: exosomes (30–100 nm), microparticles (100–1,000 nm), and apoptotic bodies (1,000–5000 nm) ( Malekpour et al, 2021 ) ( Table 1 ). In addition to the differences in their size, the biogenesis of exosomes is a hallmark feature that distinguishes them from other EVs.…”

Mesenchymal Stromal/Stem Cells and Their Extracellular Vesicles Application in Acute and Chronic Inflammatory Liver Diseases: Emphasizing on the Anti-Fibrotic and Immunomodulatory Mechanisms

“…EVs are a significant component of intercellular communication that affect the actions of the target cell by transporting various substances, including proteins, lipids, and nucleic acids, from the producing cell to the target cell ( 150 ). These vesicles are divided into microvesicles (MVs), apoptotic bodies and exosomes according to their size, internal contents, biogenesis and different surface markers ( 151 ). However, the fourth group of these vesicles, smaller than the rest, has been identified as named exomer ( 152 ).…”

“…Although there are numerous clinical trials on the use of MSCs in the treatment of liver disease, to date, no clinical trials have been performed on the use of MSC-EVs despite their benefits. However, it has been used to treat many disorders, including orthopaedic disease ( 151 ), neurodegenerative disease ( 183 ), myocardial disease ( 184 ), renal disease, graft versus host disease (GvHD), pancreatic cancer and type 1 diabetes and has shown promising results ( 185 ). Despite the therapeutic potential of MSC-EVs and their beneficial effects in preclinical studies, several issues related to the clinical use of these vesicles remain unresolved.…”

Stem Cell-Derived Exosome as Potential Therapeutics for Microbial Diseases

“…Mesenchymal Stem Cell-derived Exosomes have been reported to decrease the side effects of cell therapy ( Malekpour et al, 2021 ). Therefore, they can be a good platform for various applications in the treatment of various diseases.…”