AUTHOR=Qiao Kai , Chen Qi , Cao Yiguo , Li Jie , Xu Gang , Liu Jiaqing , Cui Xiaolin , Tian Kang , Zhang Weiguo 

TITLE=Diagnostic and Therapeutic Role of Extracellular Vesicles in Articular Cartilage Lesions and Degenerative Joint Diseases

JOURNAL=Frontiers in Bioengineering and Biotechnology

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2021.698614

DOI=10.3389/fbioe.2021.698614

ISSN=2296-4185

ABSTRACT=Cartilage lesions and degenerative joint diseases, characterized by the progressive cartilage destruction, have been one of the leading contributors to the disability globally. Current clinical treatments often fail with variable outcomes and unsatisfactory long-term repair. Cell-based therapy was once considered as an effective solution because of its anti-inflammatory and immunosuppression characteristics as well as its differentiation capacity to regenerate damaged tissue. However, the inherent limitations of the stem cell-based therapy, including high tumorigenicity risk, low retention and engraftment rate as well as strict regulation requirement, result in an underwhelming therapeutic effect. Therefore, stem cell-free based therapy has gained its popularity in recent years. Extracellular vesicles, in particular, as paracrine factors secreted by stem cells, have been proven to play a role in mediating biological functions of target cells, and can achieve similar therapeutic effect as stem cells in cartilage tissue engineering. Therefore, a comprehensive review of the therapeutic role of EVs in cartilage lesions and degenerative joint diseases can be timely and favorable. In this review, we summarized the physiological environment of joint and its pathological alteration after trauma, and consequent changes in EVs, which is lacking from the current literature. In addition, we covered the potential working mechanism of EVs in the cartilage and joint repair, and further discussed the potential therapeutic applications of EVs in future clinical use.