Published online Jul 26, 2020. doi: 10.4252/wjsc.v12.i7.688
Peer-review started: March 4, 2020
First decision: April 18, 2020
Revised: May 26, 2020
Accepted: June 10, 2020
Article in press: June 10, 2020
Published online: July 26, 2020
Mesenchymal stem cells (MSCs) have been widely investigated in rheumatic disease due to their immunomodulatory and regenerative properties. Recently, mounting studies have implicated the therapeutic potency of MSCs mostly due to the bioactive factors they produce. Extracellular vesicles (EVs) derived from MSCs have been identified as a prospective cell-free therapy due to low immunogenicity. Rheumatic disease, primarily including rheumatoid arthritis (RA) and osteoarthritis (OA), is a group of diseases in which immune dysregulation and chronic progressive inflammation lead to irreversible joint damage. Targeting MSCs and MSC-derived EVs may be a more effective and promising therapeutic strategy for rheumatic diseases.
MSCs and MSC-derived EVs have attracted increasing attention in rheumatic diseases due to their great potency in immunosuppression and tissue repair. Currently, it is of great significance to evaluate the therapeutic value by searching and summarizing the relevant literature.
To evaluate the potential therapeutic effectiveness of MSCs and EVs generated from MSCs in rheumatic diseases.
One electronic database (PubMed) was searched for the relative literature using the corresponding search terms alone or in combination. Papers published in English language from January 1999 to February 2020 were in consideration. Preliminary screening of papers concerning analysis of "immunomodulatory function" or "regenerative function" by scrutinizing the titles and abstracts of the literature, excluded the papers not related to the subject of the article. Some other related studies were obtained by manually retrieving the reference lists of papers that comply with the selection criteria, and these studies were screened to meet the final selection and exclusion criteria.
Eighty-six papers were ultimately selected for analysis. After analysis of the literature, it was proved that both MSCs and EVs generated from MSCs exert great potential in multiple rheumatic diseases, such as RA and OA, in repair and regeneration of tissues, inhibition of inflammatory response, and regulation of body immunity via promoting chondrogenesis, modulating innate and adaptive immune cells, and regulating the secretion of inflammatory factors. But EVs from MSCs exhibit much more advantages over MSCs, which may represent another promising cell-free restorative strategy. Targeting MSCs and MSC-derived EVs may be a more efficient treatment for patients with rheumatic diseases.
MSCs and MSC-derived EVs have demonstrated powerful regenerative potency, as well as their regulatory function for the innate and adaptive immune system. This study offers new ideas and possibilities for MSCs and EVs from MSCs to rheumatism treatment due to their enormous potential described above. However, more in-depth exploration is needed before their clinical application.
The great potency of MSCs and MSC-derived EVs has been demonstrated, and they can be developed as a more effective and promising therapeutic strategy for rheumatic diseases. Before application of MSCs and MSC-derived EVs into the treatment of rheumatic diseases, a large number of preclinical studies and clinical studies are required.