Osteoporosis treatment using stem cell-derived exosomes: a systematic review and meta-analysis of preclinical studies

Abstract

Background The increasing incidence of osteoporosis in recent years has aroused widespread public concern; however, existing effective treatments are limited. Therefore, new osteoporosis treatment methods, including stem cell transplantation and exosome therapy, have been proposed and are gaining momentum. Exosomes are considered to have greater potential for clinical application owing to their immunocompatibility. This study summarises the latest evidence demonstrating the efficacy of exosomes in improving bone loss in the treatment of osteoporosis. Main text This systematic review and meta-analyses searched PubMed, Embase, and Cochrane Library databases from inception to 26 March 2022 for osteoporosis treatment studies using stem cell-derived exosomes. Six endpoints were selected to determine efficacy: bone mineral density, trabecular bone volume/tissue volume fraction, trabecular number, trabecular separation, trabecular thickness, and cortical thickness. The search generated 366 citations. Eventually, 11 articles that included 15 controlled preclinical trials and 242 experimental animals (rats and mice) were included in the meta-analysis. Conclusion The results were relatively robust and reliable despite some publication biases, suggesting that exosome treatment increased bone mass, improved bone microarchitecture, and enhanced bone strength compared with placebo treatments. Moreover, stem cell-derived exosomes may favour anabolism over catabolism, shifting the dynamic balance towards bone regeneration.

The efficacy of extracellular vesicles for acute lung injury in preclinical animal models: a meta-analysis

“…Another meta-analysis have found that MSC-EVs have therapeutic potential for acute and chronic liver diseases [ 76 ]. Furthermore, several meta-analysis studies have indicated that EVs are involved in the treatment of acute kidney injury and osteoporosis [ 77 , 78 ]. However, some studies have suggested that EVs may not only have a therapeutic effect in disease development but may also contribute to disease progression.A study found that the increase of peripheral blood miR-1298-5p in sepsis-associated ALI patients triggered lung inflammation by inhibiting the proliferation of human bronchial epithelial cells and inducing epithelial permeability changes [ 79 ].…”

Exosomes as a potential therapeutic approach in osteoimmunology

“…Osteoporosis is a metabolic bone disease characterized by a deterioration of bone tissue structure, a reduction in bone mass, and a predisposition to fractures ( 46 ). Exosomes have great potential for clinical use due to their immunocompatibility ( 47 ). The therapeutic potential of exosomes obtained from osteoblast cultures is currently of great interest.…”

To the 100th anniversary of the birth of academician V.A. Nasonova. Osteoporosis: Yesterday, today, tomorrow

“…в патогенезе ОП [78][79][80][81]. Перспективными направлениями лечения ОП предполагается использование экзосом, полученных из стволовых мезенхимальных клеток, мелатонина, пробиотиков, альфа-кетоглутарата, и сенолитиков [78,79,82].…”