4.8 Article

Enhanced Osteolysis Targeted Therapy through Fusion of Exosomes Derived from M2 Macrophages and Bone Marrow Mesenchymal Stem Cells: Modulating Macrophage Polarization

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SMALL
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WILEY-V C H VERLAG GMBH
DOI: 10.1002/smll.202303506

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aseptic loosening; fused exosomes; macrophage polarization; peri-prosthetic osteolysis; targeted therapies

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Aseptic loosening of prostheses is a significant issue, and exosomes derived from bone marrow mesenchymal stem cells (BMSCs-Exos) and M2 macrophages (M2-Exos) show potential for targeted therapy in preventing and treating peri-prosthetic osteolysis.
Aseptic loosening of prostheses is a highly researched topic, and wear particle-induced macrophage polarization is a significant cause of peri-prosthetic osteolysis. Exosomes derived from bone marrow mesenchymal stem cells (BMSCs-Exos) promote M2 polarization and inhibit M1 polarization of macrophages. However, clinical application problems such as easy clearance and lack of targeting exist. Exosomes derived from M2 macrophages (M2-Exos) have good biocompatibility, immune escape ability, and natural inflammatory targeting ability. M2-Exos and BMSCs-Exos fused exosomes (M2-BMSCs-Exos) are constructed, which targeted the osteolysis site and exerted the therapeutic effect of both exosomes. M2-BMSCs-Exos achieved targeted osteolysis after intravenous administration inhibiting M1 polarization and promoting M2 polarization to a greater extent at the targeted site, ultimately playing a key role in the prevention and treatment of aseptic loosening of prostheses. In conclusion, M2-BMSCs-Exos can be used as a precise and reliable molecular drug for peri-prosthetic osteolysis. Fused exosomes M2-BMSCs-Exos were originally proposed and successfully prepared, and exosome fusion technology provides a new theoretical basis and solution for the clinical application of therapeutic exosomes. Schematic illustration of the preparation of M2-BMSCs-Exos and its therapeutic effect for peri-prosthetic osteolysis. M2-BMSCs-Exos achieved targeted osteolysis to inhibit M1 polarization and promote M2 polarization to a greater extent. M2-BMSCs-Exos can be used as a precise and reliable molecular drug for the prevention and treatment of peri-prosthetic osteolysis.image

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