Exosome and other extracellular vesicles for bone diseases

Bone diseases, ranging from degenerative disorders like osteoporosis to malignant conditions such as bone metastasis, present significant challenges to healthcare systems worldwide due to their prevalence, morbidity, and economic burden. Factors like aging populations, sedentary lifestyles, and poor nutrition contribute to their increasing burden. Innovative research efforts aimed at understanding disease mechanisms and developing novel treatments, including those involving exosomes and extracellular vesicles, hold promise for improving outcomes in bone diseases. Exosomes are involved in intercellular communication and play critical roles in bone homeostasis and disease pathogenesis. They carry a cargo of proteins, bioactive molecules, and nucleic acids influencing cellular processes and physiological functions. Exosomes derived from various cell types within the microenvironment regulate osteogenic differentiation, osteoclastogenesis, and bone resorption. Moreover, they contribute to bone tissue engineering by promoting osteoblast proliferation, angiogenesis, and mineralization. Osteoblast-derived exosomes enhance osteogenic differentiation and bone formation by delivering osteogenic factors and miRNAs. They also modulate osteoclast activity, thus affecting bone remodeling. Conversely, osteoclast-derived exosomes regulate osteoblast function and bone resorption, highlighting the intricate balance within the bone microenvironment. In bone diseases like osteoporosis, osteoarthritis, and bone metastasis, exosomes play multifaceted roles. They contribute to disease progression by influencing cartilage degradation, inflammation, and tumor-induced bone remodeling. However, they also offer therapeutic potential, with exosome-based approaches showing promise in promoting bone regeneration, mitigating inflammation, and preventing metastatic spread. Overall, exosomes represent promising targets for therapeutic intervention in bone diseases. Understanding their roles in disease pathogenesis and bone regeneration could lead to the development of novel diagnostic tools and treatment modalities, improving outcomes and quality of life for patients with bone diseases.