背景:尽管间充质干细胞及其释放的外泌体有望成为治愈骨性关节炎的新措施,但具体的分子机制尚不清楚.目的:在理解骨性关节炎发病主要机制和间充质干细胞重要特点的基础上,了解外泌体在间充质干细胞治疗骨性关节炎中的作用与机制.方法:查阅2006至2016年期间,国内外有关骨性关节炎与外泌体、间充质干细胞来源外泌体与骨性关节炎的文献.检索词分别为"外泌体,间充质干细胞,骨性关节炎"和"exosomes,mesenchymal stem cells, osteoarthritis".最后选择38篇文献纳入结果分析.结果与结论:骨性关节炎是一类与年龄、劳损等相关的难治性疾病,采用间充质干细胞治疗已取得良好疗效.间充质干细胞的成软骨分化、微环境改善、旁分泌及外泌体作用等机制已被不断报道.外泌体可通过转运不同的生物活性蛋白质、脂质、核酸等分子介导细胞间信号转导和生物应答,与骨性关节炎发病机制有关,也涉及间充质干细胞所引起的骨关节组织再生修复.间充质干细胞分泌的外泌体可以通过改变膜交换和转运活性分子来促进骨关节组织再生,为确定骨性关节炎治疗新策略提供了新思路.%BACKGROUND: Although mesenchymal stem cells (MSCs) and MSCs-released exosomes are expected to become a new means for osteoarthritis, the concrete molecular mechanisms remain unclear yet. OBJECTIVE: To understand the effect and mechanism of exosomes in the MSC treatment of osteoarthritis based on the main pathogenesis of osteoarthritis and characteristics of MSCs. METHODS: Domestic and foreign articles concerning MSCs and MSCs-released exosomes for the osteoarthritis treatment published from 2006 to 2016 were retrieved and analyzed. The keywords used were "exosomes, mesenchymal stem cells, osteoarthritis" in Chinese and English, respectively. RESULTS AND CONCLUSION: Osteoarthritis is a refractory disease associated with age and strain, and MSCs therapy has been obtained a good effect. Cartilage differentiation, microenvironment improvement, paracrine and exosomes mechanism of MSCs have also been reported. Exosomes play an important role in mediating intercellular signal transduction and biological responses by transferring a variety of biologically active proteins, lipids, nucleic acids and other molecules. The changes are not only related to the osteoarthritis pathogenesis, but also involved in MSCs induced regeneration and repair of bone and joint tissues. Exosomes secreted by MSCs can improve bone and joint tissue regeneration through membrane exchange and transport of active molecules. This will provide a new insight into the osteoarthritis treatment.
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