The crosstalk among macrophages, chondrocytes and mesenchymal stem cells in osteoarthritis: the role of extracellular vesicles

Osteoarthritis (OA), as a complex degenerative disease, involves the interaction among macrophages, chondrocytes and mesenchymal stem cells (MSCs) in its pathogenesis. In recent years, extracellular vesicles (EVs), as important mediators of intercellular communication, have attracted much attention due to their potential in tissue repair and immune regulation. This review explores the role of EVs in the treatment of OA, particularly their functions in the crosstalk among macrophages, chondrocytes and MSCs. EVs carry bioactive molecules such as miRNAs and proteins, and influence cell behavior by regulating cell signaling pathways and gene expression. In OA, EVs can promote chondrocyte proliferation, inhibit inflammation, promote cartilage repair, and regulate macrophage polarization. Additionally, EVs can also be used as drug delivery systems to enhance drug targeting and bioavailability. Despite the great potential of exosomes in the treatment of OA, there are still challenges in their extraction and purification, dose determination, and long-term safety assessment.