ReviewStem cell research & therapy2025
Mesenchymal stem cells and extracellular vesicles for knee osteoarthritis: clinical application, mechanism exploration and prospect.
Review in Stem cell research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed.
- From pathogenic to reparative: Context-Dependent function of extracellular vesicles in osteoarthritis.Bioactive materials · 2027Review
- Exosome therapy for knee osteoarthritis: a network meta-analysis based on rat models.Stem cells translational medicine · 2026Article
- Tuning Secretomes for Regenerative Medicine.Biology · 2026Review
- Progress in research on the association between mesenchymal stem cell senescence and knee osteoarthritis.Journal of orthopaedic surgery and research · 2026Review
- Mesenchymal stromal cells therapy for remodeling the joint microenvironment: mechanisms, nanotechnology-enhanced strategies, and translation prospects.Stem cell research & therapy · 2026Review
- Exosomes and Small Extracellular Vesicles as an Alternative to Mesenchymal Stromal Cell Therapy in Knee Osteoarthritis: From Biological Rationale to Clinical Evidence.International journal of molecular sciences · 2026Review
- The Infrapatellar Fat Pad in Osteoarthritis: From Pathophysiology to a Novel Therapeutic Target.International journal of molecular sciences · 2026Review
- Roles of exosomal non-coding RNAs in osteoarthritis.Frontiers in immunology · 2026Review
- Mammalian, plant, and gut microbiota-derived extracellular vesicles as emerging therapeutics for bone diseases.Frontiers in bioengineering and biotechnology · 2026Review
- Targeting subchondral osteoporosis in osteoarthritis: biomechanical crosstalk and the therapeutic rationale for inflammatory microenvironment remodeling.Frontiers in immunology · 2026Review
- A narrative review of clinical research on knee osteoarthritis in 2025.Annals of joint · 2026Review
- Chromatin remodeling and epigenetic regulation of mesenchymal stem/stromal cells in osteoarthritis.Frontiers in genetics · 2026Review
- Non-Bone-Derived Extracellular Vesicles in Osteoporosis: Evidence Mapping and Nanomedicine Translation.International journal of nanomedicine · 2026Review
- Mammalian cell-derived extracellular vesicles remodel the immune-repair microenvironment in osteoarthritis: from pathological signal transmission to regenerative therapy.Frontiers in immunology · 2026Review
- Identification of potential biomarkers related to the Bitong mixture in osteoarthritis based on bioinformatics and network pharmacology, and exploration of the mechanism involved.Frontiers in immunology · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
Knee osteoarthritis (KOA) is a prevalent degenerative joint disease characterized by progressive articular cartilage degeneration, synovial inflammation, and abnormal subchondral bone remodeling, with no curative treatment currently available. Mesenchymal stem cells (MSCs) and their extracellular vesicles (MSC-EVs) have emerged as promising therapeutic strategies for KOA due to their anti-inflammatory, regenerative, and immunomodulatory properties. Clinical studies demonstrate that intra-articular MSCs injection significantly alleviates pain, improves joint function, and exhibits a favorable safety profile. MSC-EVs show enhanced therapeutic potential owing to their low immunogenicity, high stability, and targeted delivery capabilities. This review systematically examines the therapeutic role of MSCs and MSC-EVs in KOA treatment. Mechanistic studies reveal that MSC-EVs ameliorate joint inflammatory microenvironments by regulating macrophage polarization, inhibiting key inflammatory pathways (NF-κB, MAPK), and suppressing pro-inflammatory cytokine release (IL-1β, TNF-α). Furthermore, MSC-EVs protect extracellular matrix integrity and promote cartilage regeneration by upregulating chondrogenic markers (Sox9, aggrecan, type II collagen) while downregulating matrix-degrading enzymes (MMP-13, ADAMTS5). Additionally, MSC-EVs enhance chondrocyte proliferation and migration while inhibiting apoptosis and senescence, potentially through activation of YAP and JAK/STAT signaling pathways. These multifaceted mechanisms collectively facilitate cartilage repair and regeneration. Advances in engineered EVs technology and novel delivery systems provide strategies to further enhance MSC-EVs efficacy. Engineered EVs modified with chondrocyte-targeting peptides or loaded with therapeutic molecules (drugs, miRNAs, siRNAs) can deliver bioactive compounds to specific sites and precisely regulate chondrocyte function, thereby alleviating KOA symptoms. This review comprehensively examines the clinical efficacy and underlying mechanisms of MSCs and MSC-EVs in KOA treatment, discusses current clinical application challenges, and outlines future research directions for advancing precision therapeutic strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.