Mechanism of action behind the pain-relief effects of extracellular vesicles in microfragmented adipose tissue: an in vitro and in vivo study.

Early human evidence such as case series or small samples is exploring possible benefits.

• 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)

Background Trapeziometacarpal osteoarthritis (TMC OA) is a prevalent and debilitating condition that impairs hand functionality and reduces quality of life. Current treatments including conservative measures such as splinting and anti-inflammatory medications, as well as surgical interventions often exhibit limited efficacy or involve invasive procedures. Novel therapeutic approaches are necessary to address the pain and functional limitations experienced by affected patients. Methods This study investigates the potential of extracellular vesicles (EVs) derived from autologous microfragmented adipose tissue (aMAT) as a minimally invasive treatment for TMC OA. EVs were characterized using morphological, proteomic, and functional analyses, revealing their ability to modulate cellular processes through proteins associated with extracellular matrix organization, wound healing, and inflammation regulation. Results Functional studies demonstrated that EVs modulate calcium signaling and mitochondrial activity, enhancing cellular bioenergetics and mitigating inflammation-induced dysfunction. In a clinical study with 25 patients diagnosed with TMC OA (Eaton Stage II), aMAT-derived EVs demonstrated significant benefits. Pain scores, measured by the numeric rating scale, improved substantially both at rest and during activity. Functional assessments, including the Michigan Hand Outcomes Q

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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