Chinese Journal of Tissue Engineering Research ›› 2023, Vol. 27 ›› Issue (19): 3040-3051.doi: 10.12307/2023.635

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Exosomal miRNA in the repair mechanism of degenerative diseases of the spine and joints

Zhao Yan1, Xia Qiuqiu1, Xiang Shaojie1, Mao Qiming1, Kong Weijun2, Du Qian2, Liao Wenbo2, Xin Zhijun1   

  1. 1Department of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China; 2Department of Orthopedic Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
  • Received:2022-07-22 Accepted:2022-08-27 Online:2023-07-08 Published:2022-11-28
  • Contact: Xin Zhijun, MD, Chief physician, Professor, Department of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
  • About author:Zhao Yan, Master candidate, Department of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
  • Supported by:
    Guizhou Science and Technology Fund Project, No. [2017]5733-076 (to XZJ); Doctoral Start-up Fund Project of Zunyi Medical University, No. (2022)9 (to XZJ); Project of the Department of Science and Technology of Guizhou Province, No. CXTD[2021]009 (to LWB)

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Abstract: BACKGROUND: Degenerative spondylolisthesis mainly consists of intervertebral disc degeneration and osteoarthritis. In recent years, the use of exosomal miRNAs to treat degenerative spinal joint disease by promoting autophagy and cell proliferation and migration has become a promising emerging therapeutic option.  
OBJECTIVE: To review the research progress of exosomal miRNA in the development, diagnosis and treatment mechanism of intervertebral disc degeneration and osteoarthritis.
METHODS: The first author searched the PubMed database using “intervertebral disc degeneration; osteoarthritis; exosomes; miRNA; autophagy; extracellular matrix; apoptosis; cell proliferation; pyroptosis; biomarkers; mechanistic pathways” as the keywords. Finally, 133 English articles were summarized.  
RESULTS AND CONCLUSION: (1) The main physiopathological feature of exosomal miRNA for the treatment of degenerative spinal joint diseases is to treat degenerative spinal joint diseases by promoting autophagy and cell migration and proliferation, inhibiting extracellular matrix degradation, apoptosis, cell pyroptosis and inflammatory effects in several ways. The same exosomal miRNA is able to participate in different physiopathological processes of the same disease. (2) The mechanisms and pathways of action of exosomes in the treatment of degenerative spondylolisthesis occur mainly through the Wnt/β-catenin pathway, mTOR, NLRP3, nuclear factor-κB, MAPK and other signaling pathways; the MAKP signaling pathway is a common signaling pathway in exosomal miRNA therapy to improve the process of intervertebral disc degeneration and osteoarthritis disease, which is significant for finding common targets in intervertebral disc degeneration, osteoarthritis disease and other degenerative diseases of the spine and joints. (3) The same miRNA family can be involved in the repair of different degenerative lesions, which has a significant implication for the exploration or synthesis of new type of exosomal miRNA to treat other degenerative diseases of the spine and joints, but further studies are needed to investigate the safety and adverse effects of exosomal miRNA therapy in spinal and joint degenerative diseases.

Key words: intervertebral disc degeneration, osteoarthritis, exosome, miRNA, autophagy, extracellular matrix, apoptosis, cell pyroptosis, cell proliferation, biomarker

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