Exosomes Derived from Non-Classic Sources for Treatment of Post-Traumatic Osteoarthritis and Cartilage Injury of the Knee: In Vivo Review.

Dan Li,Daniel A Grande,Nicholas A Sgaglione,Puneet Gupta

doi:10.3390/jcm10092001

Abstract

Osteoarthritis of the knee is one of the most common chronic, debilitating musculoskeletal conditions. Current conservative treatment modalities such as weight loss, non-steroidal anti-inflammatory drugs, and intra-articular steroid injections often only provide temporary pain relief and are unsatisfactory for long-term management. Though end stage osteoarthritis of the knee can be managed with total knee arthroplasty (TKA), finding alternative non-surgical options to delay or prevent the need for TKA are needed due to the increased healthcare costs and expenditures associated with TKA. Exosomes have been of particular interest given recent findings highlighting that stem cells may at least partially mediate some of their effects through the release of extracellular vesicles, such as exosomes. As such, better understanding the biological mechanisms and potential therapeutic effects of these exosomes is necessary. Here, we review in vivo studies that highlight the potential clinical use of exosomes derived from non-classical sources (not bone marrow or adipose derived MSCs derived MSCs) for osteoarthritis of the knee.

Highlights

Osteoarthritis (OA) is a leading cause of chronic disability and pain with an estimated nearly 9.6% of men and 18% of women over the age of 60 across the world suffering fromOA [1,2]
There are no drugs that directly treat the disease to prevent the pathologic progression to its end stage, to which the only treatment is total knee arthroplasty (TKA)
One study used exosomes derived from platelet-rich plasma, one from infrapatellar fat pads, three from synovial membranes, three from the umbilical cord, three from human embryonic stem cells, and one from amniotic fluid

Summary

Introduction

Osteoarthritis (OA) is a leading cause of chronic disability and pain with an estimated nearly 9.6% of men and 18% of women over the age of 60 across the world suffering fromOA [1,2]. Osteoarthritis (OA) is a leading cause of chronic disability and pain with an estimated nearly 9.6% of men and 18% of women over the age of 60 across the world suffering from. There are no drugs that directly treat the disease to prevent the pathologic progression to its end stage, to which the only treatment is total knee arthroplasty (TKA). $27 billion in healthcare costs annually can be attributed to knee OA [4,5,6]. Given such large healthcare expenditures and current inadequate multimodal treatment regimens, developing novel non-surgical or minimally invasive therapeutics is critical

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Conclusion