Mesenchymal stem cell-derived exosomes for the treatment of knee osteoarthritis: a systematic review and meta-analysis based on rat model

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• 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 In this study, we systematically evaluated the efficacy of mesenchymal stem cell (MSC) derived exosomes (MSC-exos) in the treatment of osteoarthritis (OA) through multimodal evaluation of cartilage protection, anti-inflammatory activity and tissue regeneration. A comparative analysis of drug delivery strategies was performed to explore better therapeutic effects. Methods The study employed a systematic search of PubMed, Embase, and Web of Science databases for comparative studies on exosome treatments in rat knee OA models with cartilage damage up to July 2024. Two researchers independently reviewed the literature, extracted data, evaluated bias, and conducted a meta-analysis using RevMan 5.4.1, Stata IC 15, and Stata 18. Results Our systematic review incorporated 28 preclinical studies demonstrating that MSC-exos consistently exhibited therapeutic advantages in cartilage repair, as evidenced by significant improvements across validated histological scoring systems, such as Osteoarthritis Research Society International (OARSI), Mankin, and International Cartilage Repair Society (ICRS) metrics. Mechanistic analyses revealed coordinated anabolic-catabolic modulation, with marked upregulation of cartilage-specific anabolic factors including collagen type II, aggrecan core protein, and interleukin-10. Concomitantly, MSC-exos suppressed pro-inflammatory mediators through

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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