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已发表论文
外泌体作为原发性骨质疏松症新兴治疗策略：综述性评论
Authors Chen G , Li H, Chen R, Chen G
Received 2 July 2025
Accepted for publication 21 September 2025
Published 7 October 2025 Volume 2025:19 Pages 9099—9115
DOI https://doi.org/10.2147/DDDT.S550797
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 5
Editor who approved publication: Professor Anastasios Lymperopoulos
Guangmou Chen,1,2 Hongqiang Li,2 Rihao Chen,2 Guanghua Chen1,2
1Jinan University, Guangzhou, Guangdong Province, People’s Republic of China; 2Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People’s Republic of China
Correspondence: Guanghua Chen, Jinan University, No. 601, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, People’s Republic of China, Email chenguanghua@gdmu.edu.cn
Background: Primary osteoporosis imposes a growing global burden. While antiresorptive and anabolic agents reduce fractures, long-term adherence, adverse events, and limited tissue targeting leave unmet needs. Exosomes have emerged as promising, cell-free candidates.
Methods: We conducted a narrative synthesis of English-language studies (2010–May 2025) indexed in PubMed and Web of Science on exosomes and primary osteoporosis, including mechanistic, preclinical efficacy, delivery, and safety data.
Results: Exosomes modulate bone remodeling via osteoanabolic signaling, osteoclast inhibition, and antioxidative pathways. Across cell and animal models, exosome preparations improved osteoblast viability and function, enhanced mineralization, and mitigated glucocorticoid- or estrogen-deficiency–related bone loss. Key translational variables include source selection, isolation/characterization, cargo loading, dosing, route, targeting, and biocompatibility. Safety signals are preliminarily favorable but heterogeneous across platforms. The current evidence base is predominantly preclinical; standardized manufacturing, biodistribution and persistence profiling, and dose–response relationships remain insufficient.
Conclusion: Exosome-based approaches are promising adjuncts rather than immediate replacements for current osteoporosis therapies. Priorities include harmonized release criteria, head-to-head comparisons with standard agents, validated pharmacodynamic biomarkers, and early-phase clinical trials.
Clinical Relevance: For patients who are intolerant of or inadequately controlled by approved agents, exosome strategies may offer future targeted adjuncts once quality, safety, and efficacy are established in humans.
Keywords: exosomes, primary osteoporosis, bone regeneration, drug delivery, targeted therapy
1Jinan University, Guangzhou, Guangdong Province, People’s Republic of China; 2Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, People’s Republic of China
Correspondence: Guanghua Chen, Jinan University, No. 601, Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province, People’s Republic of China, Email chenguanghua@gdmu.edu.cn
Background: Primary osteoporosis imposes a growing global burden. While antiresorptive and anabolic agents reduce fractures, long-term adherence, adverse events, and limited tissue targeting leave unmet needs. Exosomes have emerged as promising, cell-free candidates.
Methods: We conducted a narrative synthesis of English-language studies (2010–May 2025) indexed in PubMed and Web of Science on exosomes and primary osteoporosis, including mechanistic, preclinical efficacy, delivery, and safety data.
Results: Exosomes modulate bone remodeling via osteoanabolic signaling, osteoclast inhibition, and antioxidative pathways. Across cell and animal models, exosome preparations improved osteoblast viability and function, enhanced mineralization, and mitigated glucocorticoid- or estrogen-deficiency–related bone loss. Key translational variables include source selection, isolation/characterization, cargo loading, dosing, route, targeting, and biocompatibility. Safety signals are preliminarily favorable but heterogeneous across platforms. The current evidence base is predominantly preclinical; standardized manufacturing, biodistribution and persistence profiling, and dose–response relationships remain insufficient.
Conclusion: Exosome-based approaches are promising adjuncts rather than immediate replacements for current osteoporosis therapies. Priorities include harmonized release criteria, head-to-head comparisons with standard agents, validated pharmacodynamic biomarkers, and early-phase clinical trials.
Clinical Relevance: For patients who are intolerant of or inadequately controlled by approved agents, exosome strategies may offer future targeted adjuncts once quality, safety, and efficacy are established in humans.
Keywords: exosomes, primary osteoporosis, bone regeneration, drug delivery, targeted therapy