Osteoarthritis (OA) is the most common painful disease with chronic articular cartilage degeneration. The pathological process of OA is complex and characterized by the imbalance between the synthesis and catabolism of chondrocytes and extracellular matrix, leading to the progressive destruction of articular cartilage damage. Because of the self-renewal and differentiation of mesenchymal stem cells (MSCs), various exogenous MSC-based cell therapies have been developed to treat OA. Moreover, the efficacy of MSC- based therapy is mainly attributed to the paracrine of cytokines, growth factors, and exosomes. Exosomes derived from MSCs can deliver various DNAs, RNAs, proteins and lipids, thus promoting MSCs migration and cartilage repair. Therefore, MSC-derived exosomes are considered as a promising alternative therapy for OA. In this review, we summarized properties of MSC-derived exosomes and the new role of MSC-derived exosomes in the treatment of OA. We also proposed possible perspectives of MSC-derived exosomes as cell-free regenerative reagents in the treatment of OA.

骨关节炎 (OA) 是最常见的慢性关节软骨退行性疼痛疾病。OA的病理过程复杂，以软骨细胞和细胞外基质的合成和分解代谢失衡为特征，导致关节软骨损伤的进行性破坏。由于间充质干细胞 (MSC) 的自我更新和分化，已经开发出各种基于外源性 MSC 的细胞疗法来治疗 OA。此外，基于 MSC 的疗法的功效主要归因于细胞因子、生长因子和外泌体的旁分泌。源自MSCs的外泌体可以传递各种DNA、RNA、蛋白质和脂质，从而促进MSCs迁移和软骨修复。因此，MSC 衍生的外泌体被认为是一种有前途的 OA 替代疗法。在这次审查中，我们总结了 MSC 衍生的外泌体的特性以及 MSC 衍生的外泌体在治疗 OA 中的新作用。我们还提出了 MSC 衍生的外泌体作为无细胞再生试剂治疗 OA 的可能观点。