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Extracellular vesicles — new tool for joint repair and regeneration

Abstract

Cell-derived extracellular vesicles (EVs), present in synovial fluid and cartilage extracellular matrix (ECM), are involved in joint development and in the regulation of joint homeostasis. Although the exact function of EVs in these processes remains incompletely defined, the knowledge already acquired in this field suggests a role for these EVs as biomarkers of joint disease, and as a new tool to restore joint homeostasis and enhance articular tissue regeneration. In addition to direct injection of therapeutic EVs into the target site, surface coating of scaffolds and embedding of EVs in hydrogels might also lead to novel therapeutic possibilities. Based on the existing literature of EVs in synovial fluid and articular tissues, and investigation of the molecular factors (including microRNAs) active in joint homeostasis (or during its disturbance), we postulate novel perspectives for the implementation of EVs as a regenerative medicine approach in joint repair.

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Figure 1: Proposed mechanisms of EV-mediated communication in inflammatory joint disease.
Figure 2: Proposed applications of EVs in joint disease.

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Acknowledgements

The authors' research work is supported by the Dutch Arthritis Foundation (grant numbers LLP-12 and LLP-22; J.M., P.R.W.), the EU Seventh Framework Programme (FP7/2007–2013, grant agreement 309962 [HydroZONES]) (J.M.), the European Research Council (grant agreement 647426 [3D-JOINT]) (J.M., P.R.W.), and a grant from the Dutch government to the Netherlands Institute for Regenerative Medicine (NIRM, grant number FES0908) (J.B.).

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J.M. and J.B. contributed equally to researching data for the article and writing the manuscript. All authors made substantial contributions to discussion of content and to review and edit the manuscript before submission.

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Correspondence to Marca H. M. Wauben.

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Malda, J., Boere, J., van de Lest, C. et al. Extracellular vesicles — new tool for joint repair and regeneration. Nat Rev Rheumatol 12, 243–249 (2016). https://doi.org/10.1038/nrrheum.2015.170

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