Extracellular vesicles derived from mesenchymal stem cells mediate extracellular matrix remodeling in osteoarthritis through the transport of microRNA-29a

Advances in Cell-based therapies for peripheral arterial disease

PURPOSE

To examine recent advances in cell-based therapies for peripheral arterial disease (PAD), focusing on mechanisms of action, clinical applications, and regulatory considerations. The review aimed to evaluate the therapeutic potential of various cell types and assess their efficacy in addressing the unmet needs of PAD patients,particularly those with critical limb ischemia (CLI).

METHODS

The review analysed current literature on cell-based therapies for PAD, including preclinical studies using animal models, clinical trials from phase I to III, and regulatory frameworks. Multiple cell types were evaluated, including mesenchymal stem cells (MSCs), endothelial progenitor cells (EPCs), bone marrow mononuclear cells (BMMNCs),and adipose-derived stem cells (ADSCs).

RESULTS

Preclinical studies demonstrated significant improvements in limb perfusion and neovascularization across various cell types. Clinical trials, particularly those utilizing MSCs and BM-MNCs, showed encouraging outcomes in wound healing and reduced amputation rates. The therapeutic effects were mediated through multiple mechanisms, including direct vessel formation, paracrine signalling, immunomodulation, and tissue repair. The FDA's implementation of a tiered, risk-based system for human cells, tissues, and cellular and tissue-based products (HCT/Ps) has provided a regulatory framework balancing innovation with safety.

CONCLUSION

Cell-based therapies show promising potential for PAD treatment, particularly for patients with limited conventional treatment options. While clinical trials demonstrate encouraging results, challenges remain in standardizing cell characterization methods and establishing appropriate potency assays. Future research should focus on optimizing cell delivery methods, identifying the most effective cell types, and conducting larger clinical trials to establish definitive efficacy.

Mesenchymal stem cell-derived exosomes as a plausible immunomodulatory therapeutic tool for inflammatory diseases

Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs), especially, exosomes are considered to have diverse therapeutic effects for various significant diseases. MSC-derived exosomes (MSCex) offer substantial advantages over MSCs due to their long-term preservation, stability, absence of nuclei and fewer adverse effects such as infusion toxicity, thereby paving the way towards regenerative medicine and cell-free therapeutics. These exosomes harbor several cellular contents such as DNA, RNA, lipids, metabolites, and proteins, facilitating drug delivery and intercellular communication. MSCex have the ability to immunomodulate and trigger the anti-inflammatory process hence, playing a key role in alleviating inflammation and enhancing tissue regeneration. In this review, we addressed the anti-inflammatory effects of MSCex and the underlying immunomodulatory pathways. Moreover, we discussed the recent updates on MSCex in treating specific inflammatory diseases, including arthritis, inflammatory bowel disease, inflammatory eye diseases, and respiratory diseases such as asthma and acute respiratory distress syndrome (ARDS), as well as neurodegenerative and cardiac diseases. Finally, we highlighted the challenges in using MSCex as the successful therapeutic tool and discussed future perspectives.

Current status, opportunities, and challenges of exosomes in diagnosis and treatment of osteoarthritis

Osteoarthritis (OA) is a progressive joint disease that is a frequent reason for pain and physical dysfunction in adults, with enormous social and economic burden. Although ongoing scientific efforts in recent years have made considerable progress towards understanding of the disease's molecular mechanism, the pathogenesis of OA is still not fully known, and its clinical challenge remains. Thus, elucidating molecular events underlying the initiation and progression of OA is crucial for developing novel diagnostic and therapeutic approaches that could facilitate effective clinical management of the illness. Exosomes, extracellular vesicles containing various cellular components with approximately a diameter of 100 nm, act as essential mediators in physiological and pathological processes by modulating cell-to-cell communications. Exosomes have crucial roles in biological events such as intercellular communication, regulation of gene expression, apoptosis, inflammation, immunity, maturation and differentiation due to their inner composition, which includes nucleic acids, proteins, and lipids. We focus on the roles of exosomes in OA pathogenesis and discuss how they might be used in clinical practice for OA diagnosis and treatment. Our paper not only provides a comprehensive review of exosomes in OA but also contributes to the development efforts of diagnostic and therapeutic tools for OA.

Additional comments on extracellular vesicles derived from mesenchymal stem cells mediate extracellular matrix remodeling in osteoarthritis

Recently, we read an article published by the Yang et al. The results of this study indicated that engineered exosomes loaded with microRNA-29a (miR-29a) alleviate knee inflammation and maintain extracellular matrix stability in Sprague Dawley rats. The study's results provide useful information for treating knee osteoarthritis (KOA). This letter, shares our perspectives on treating KOA using engineered exosomes for miR-29a.