Title : Msc-exosomes in osteoarthritis treatment
Abstract:
Osteoarthritis(OA) is the most common degenerative joint disease in adults, as well as a major cause of pain and disability. Despite its broad prevalence and severe impact both on individual health and economic level, the available treatments hardly manage to calm the pain and, more importantly, lack the capability to restore degraded cartilage or decelerate disease progression. The need to find a treatment to effectively reduce pain and improve functionality in the damaged joints seems to be possible with the use of mesenchymal stem cells (MSCs). Those cells, ideally autologous, can be obtained from adipose tissue or bone-marrow (among other sources) and may be differentiated into lineages of interest, like chondrocyte or osteoblast in this case. MSCs have a dual functionality interesting in OA treatment: immunoregulation and regeneration, a combination that allows to reduce pain and inflammation as well as to repair injured tissue. Later studies demonstrate that these properties could also be found in some nanovesicles that those cells secrete, the exosomes. The use of exosomes is a step further in the way of finding the ideal treatment in OA: they have low or no immunogenicity (therefore its allogenic use a suitable option) and can be easily stored either frozen or lyophilized. Thanks to these characteristics, exosomes can be obtained from a healthy donor and produced in great quantities to create a bank, from which single doses can be distributed to any clinician desiring to treat any patient. Contrary to MSCs transplant, allogenic usually increase waiting time for the patient and could even cause losing the opportunity to treat those individuals who do not meet the criteria for that kind of intervention. Moreover, the possibility to store and send the product abroad, could allow sending the treatment to any health center even if they have no laboratory to produce exosomes themselves. In our experience, this treatment can restore damaged joints even in cases where other therapeutic options failed, improving the patient’s health and quality of life.
