The future of osteoarthritis treatment: exploring the potential of exosomes from adipose tissue-derived stem cells : a scoping review.

Several human studies show positive signals, while research methods and sample sizes continue to develop.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Aims This review examines the therapeutic potential of adipose tissue-derived stem cell (ADSC) exosomes for osteoarthritis (OA), focusing on their anti-inflammatory and cartilage regeneration properties. Methods A PubMed search (2012 to 2024) was conducted using keywords related to ADSCs, exosomes, and OA. Inclusion criteria focused on studies investigating ADSCs and ADSC-exosomes characteristics, animal OA models, and human OA patients. Exclusion criteria included case reports, case series, and conference abstracts. Results ADSCs are an abundant stem cell source with low immunogenicity. ADSC-exosomes exhibit anti-inflammatory effects and promote cartilage regeneration via miRNA transport. Preclinical studies demonstrate inhibition of synovial thickening, cartilage destruction, and macrophage activity. Clinical trials suggest that intra-articular ADSCs are safe and effective, with higher doses improving pain relief and cartilage regeneration. Conclusion ADSC-exosomes are a promising cell-free therapy for OA, with reduced immune rejection and tumorigenicity compared to ADSC transplantation. Standardizing exosome isolation and production remains a challenge. Further research is needed to confirm long-term safety and efficacy in humans.

Evidence level

Several human studies show positive signals, while research methods and sample sizes continue to develop.

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