Exosome Based Therapy for Osteoarthritis: A Systematic Review

Author(s): Torbjörn Ogéus DC, PgD, MSc, ScA

Introduction: Osteoarthritis (OA) is a chronic degenerative joint disease characterized by the progressive breakdown of articular cartilage, subchondral bone changes, and synovial inflammation. Recent advances in regenerative medicine have focused on exosome-based therapies as a promising approach to address this challenge. Exosomes, small extracellular vesicles derived from various cell types, play crucial roles in intercellular communication and tissue homeostasis. These exosomes demonstrate the capacity to modulate inflammatory responses, promote chondrocyte proliferation, and enhance extracellular matrix synthesis. Understanding the mechanisms underlying exosome-mediated tissue repair and their interactions within the joint microenvironment is crucial for the development of effective exosome-based therapies for OA.

Methods: A systematic search was undertaken across Pubmed, Google Scholar and Scopus for relevant studies published from 2014 to 2024. Keywords included “"exosomes", "stem cells", "osteoarthritis", "chondrocytes", "amniotic fluid", and "regenerative medicine".

Results: This systematic review yielded a total of 390 articles. After the removal of duplicates and an initial abstract and title screening 201 fulltext articles were assessed for eligibility. Of these, 27 studies met the inclusion criteria and were included in this review.

Conclusion: In conclusion, exosome-based therapies hold tremendous promise for the treatment of osteoarthritis by harnessing their regenerative and anti-inflammatory properties. While further research is needed to address technical and clinical challenges, the growing body of preclinical evidence supports the potential of exosomes as a novel therapeutic strategy in OA management, however more clinical trials and human studies are warranted.