Bone marrow mesenchymal stromal cell-derived exosomes in knee osteoarthritis: Bridging mechanistic understanding to clinical applications

Table 1 Selected bone marrow mesenchymal stromal cell-exosomal microRNAs and long noncoding RNAs relevant to knee osteoarthritis

Cargo species	Principal targets/pathways (examples)	Main joint-level effects (preclinical)	Ref.
miR-140-5p	ADAMTS5, MMP-13, IGFBP5, Notch and Wnt components	Promotes chondrogenesis and matrix synthesis; suppresses catabolic enzymes and hypertrophic signalling	[34,35]
miR-127-3p	Cadherin-11 and Wnt/β-catenin signalling	Inhibits chondrocyte hypertrophy and cartilage calcification	[34,45]
miR-92a-3p	WNT5A and associated kinases	Increases COL2A1 and aggrecan; reduces MMP expression	[34,46]
miR-129-5p	HMGB1 and TLR4/NF-κB axis	Dampens synovial inflammation and chondrocyte apoptosis	[35,41]
miR-223	NLRP3 inflammasome components	Inhibits pyroptosis in chondrocytes and macrophages	[35,43]
miR-100-5p	mTOR	Enhances autophagy and survival in stressed chondrocytes	[35,47]
lncRNA KLF3-AS1	Sponges miR-206, maintains GIT1	Supports PI3K/Akt signalling; promotes chondrocyte proliferation and survival	[47]
lncRNA SNHG7	miR-485-5p/FSP1 axis	Anti-ferroptotic and anti-senescent effects in cartilage	[36]

ADAMTS5: A disintegrin and metalloproteinase with thrombospondin motifs 5; MMP-13: Matrix metalloproteinase-13; IGFBP5: Insulin-like growth factor-binding protein 5; COL2A1: Collagen type II alpha 1; HMGB1: High mobility group B1; TLR4: Toll-like receptor 4; NF-κB: Nuclear factor kappa B; NLRP3: Nod-like receptor protein 3; mTOR: Mechanistic target of rapamycin; GIT1: G protein-coupled receptor kinase-interactor 1; PI3K: Phosphatidylinositol 3-kinase; Akt: Protein kinase B; FSP1: Ferroptosis suppressor protein 1.