Extracellular vesicles: From bone development to regenerative orthopedics.
Extracellular vesicles: From bone development to regenerative orthopedics.
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细胞外囊泡：从骨骼发育到再生骨科。
DOI：
10.1016/j.ymthe.2023.02.021
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Davies OG
中科院分区：
文献类型：
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作者：
Davies OG
再生医学旨在促进因损伤或疾病而失去的组织的替代。虽然在实验中观察到了积极的结果，但在临床转化中仍然存在挑战。这导致人们对应用细胞外囊泡（EV）来增强甚至取代现有方法的兴趣越来越大。通过培养环境的工程化或EV本身的直接/间接操纵，已经出现了多种途径来调节EV产生、靶向和治疗效力。使用材料系统调节释放或使植入物功能化以改善骨整合的驱动力也导致了可能具有现实影响的结果。本综述的目的是突出应用电动汽车治疗骨骼缺陷的优势，概述了该领域的最新技术水平，并强调了进一步研究的途径。值得注意的是，审查确定EV命名法的不一致性和定义可重复治疗剂量的突出挑战。在治疗有效和纯EV产品的可扩展制造中也存在挑战，需要解决可扩展的细胞来源和最佳培养环境。如果我们要开发满足监管机构要求的再生EV疗法，并且可以从实验室转化为床边，那么解决这些问题将至关重要。
Regenerative medicine aims to promote the replacement of tissues lost to damage or disease. While positive outcomes have been observed experimentally, challenges remain in their clinical translation. This has led to growing interest in applying extracellular vesicles (EVs) to augment or even replace existing approaches. Through the engineering of culture environments or direct/indirect manipulation of EVs themselves, multiple avenues have emerged to modulate EV production, targeting, and therapeutic potency. Drives to modulate release using material systems or functionalize implants for improved osseointegration have also led to outcomes that could have real-world impact. The purpose of this review is to highlight advantages in applying EVs for the treatment of skeletal defects, outlining the current state of the art in the field and emphasizing avenues for further investigation. Notably, the review identifies inconsistencies in EV nomenclature and outstanding challenges in defining a reproducible therapeutic dose. Challenges also remain in the scalable manufacture of a therapeutically potent and pure EV product, with a need to address scalable cell sources and optimal culture environments. Addressing these issues will be critical if we are to develop regenerative EV therapies that meet the demands of regulators and can be translated from bench to bedside.