Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 15, 2024; 15(12): 2399-2403
Published online Dec 15, 2024. doi: 10.4239/wjd.v15.i12.2399
Mesenchymal stem cell-derived extracellular vesicles: A promising therapeutic strategy in diabetic osteoporosis
Ya-Jing Yang, Xi-Er Chen, Xu-Chang Zhou, Feng-Xia Liang
Ya-Jing Yang, Department of Acupuncture and Moxibustion, Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China
Xi-Er Chen, College of Sports Medicine, Wuhan Sports University, Wuhan 430079, Hubei Province, China
Xu-Chang Zhou, School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
Feng-Xia Liang, Preventive Treatment of Acupuncture and Moxibustion of Hubei Provincial Collaborative Innovation Center, College of Acupuncture-Moxibustion and Orthopaedics of Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China
Co-first authors: Ya-Jing Yang and Xi-Er Chen.
Author contributions: Yang YJ and Chen XE contribute equally to this study as co-first authors. Liang FX and Zhou XC designed and coordinated the article; Yang YJ and Chen XE wrote the manuscript; all authors approved the final version of the article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Feng-Xia Liang, Doctor, PhD, Chief Physician, Professor, Preventive Treatment of Acupuncture and Moxibustion of Hubei Provincial Collaborative Innovation Center, College of Acupuncture-Moxibustion and Orthopaedics of Hubei University of Chinese Medicine, No. 1 West Huangjiahu Road, Qingling Street, Hongshan District, Wuhan 430065, Hubei Province, China. fxliang5@hotmail.com
Received: August 11, 2024
Revised: September 27, 2024
Accepted: October 30, 2024
Published online: December 15, 2024
Processing time: 98 Days and 13 Hours
Abstract

Diabetic osteoporosis (DOP) is a serious complication of diabetes mellitus. It is urgent to explore efficient clinical treatment strategies for DOP. It has been found that mesenchymal stem cell-derived extracellular vesicles (MSC-EVs), as an emerging cell-free therapy, show great potential in DOP treatment. MSC-EVs can effectively promote bone formation, inhibit bone resorption, and modulate the inflammatory microenvironment by delivering cargoes of microRNAs, long non-coding RNAs, and proteins to target cells, thereby ameliorating bone loss in DOP. However, there are limited reports on the treatment of DOP with MSC-EVs. To evoke more attention to this potential strategy, this article summarised the extant literature on MSC-EVs for DOP to provide new directions for further research and to promote the application of MSC-EVs in the clinical management of DOP.

Keywords: Bone marrow mesenchymal stem cells; Adipose-derived mesenchymal stem cells; extracellular vesicles; MicroRNAs; Long non-coding RNAs; Diabetic osteoporosis

Core Tip: A sustained high-glucose microenvironment may impair bone homeostasis leading to the initiation and progression of diabetic osteoporosis (DOP) in patients with diabetes mellitus (DM). Correcting the uncoupled bone remodelling and inflammatory microenvironment is the key to treating DOP. Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) have received widespread attention due to their ability to promote bone regeneration and inhibit bone loss in the treatment of osteoporosis by targeting the delivery of modifiable cargoes. This suggests that MSC-EVs also have great potential for the treatment of DOP, although the condition of DOP patients is more complex due to the fact that DOP patients are usually also accompanied by multiple cardiovascular and cerebrovascular complications and long-term use of multiple medications. Rapid advances in genetic engineering and bioengineering have also enabled modifiable MSC-EVs to show significant advantages in personalised and tailored treatment cases. More studies are needed to further demonstrate and develop the clinical therapeutic potential of MSC-EVs in DOP.