Curry ZA, Beling A and Borg-Stein J: Knee osteoarthritis in midlife women: Unique considerations and comprehensive management. Menopause. 29:748–755. 2022. View Article : Google Scholar : PubMed/NCBI

Ren JL, Yang J and Hu W: The global burden of osteoarthritis knee: A secondary data analysis of a population-based study. Clin Rheumatol. 44:1769–1810. 2025. View Article : Google Scholar : PubMed/NCBI

Lv Y, Sui L, Lv H, Zheng J, Feng H and Jing F: Burden of knee osteoarthritis in China and globally from 1992 to 2021, and projections to 2030: A systematic analysis from the Global Burden of Disease Study 2021. Front Public Health. 13:15431802025. View Article : Google Scholar : PubMed/NCBI

Muñoz M, Robinson K and Shibli-Rahhal A: Bone health and osteoporosis prevention and treatment. Clin Obstet Gynecol. 63:770–787. 2020. View Article : Google Scholar : PubMed/NCBI

Zhou G, Zhang X, Gu Z, Zhao J, Luo M and Liu J: Research progress on the treatment of knee osteoarthritis combined with osteoporosis by single-herb Chinese medicine and compound. Front Med (Lausanne). 10:12540862023. View Article : Google Scholar : PubMed/NCBI

Qu Y, Chen S, Han M, Gu Z, Zhang Y, Fan T, Zeng M, Ruan G, Cao P, Yang Q, et al: Osteoporosis and osteoarthritis: A bidirectional Mendelian randomization study. Arthritis Res Ther. 25:2422023. View Article : Google Scholar

Zamzam M, Alamri MS, Aldarsouni FG, Al Zaid H and Al Ofair AA: Impact of osteoporosis in postmenopausal women with primary knee osteoarthritis. Cureus. 15:e406452023.PubMed/NCBI

Zafeiris EP, Babis GC, Zafeiris CP and Chronopoulos E: Association of vitamin D, BMD and knee osteoarthritis in postmenopausal women. J Musculoskelet Neuronal Interact. 21:509–516. 2021.PubMed/NCBI

Tsai CJ, Wang YW, Chen JF, Chou CK, Huang CC and Chen YC: Factors associated with osteoarthritis in menopausal women: A registry study of osteoporosis sarcopenia and osteoarthritis. J Family Med Prim Care. 12:1859–1863. 2023. View Article : Google Scholar : PubMed/NCBI

Li D, Wan Y, Sun Y and Wu X: Clinical study of correlation between osteoporosis and osteoarthritis of knee joint using gold nanomaterial contrast agent. J Nanosci Nanotechnol. 20:7761–7768. 2020. View Article : Google Scholar : PubMed/NCBI

Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, et al: Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: The research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab. 27:620–628. 2009. View Article : Google Scholar : PubMed/NCBI

Zhang L, Tanaka K, Smith ER, Müller H, Wang X, González C, Kim M, Rossi F, Patel J, Nguyen T, et al: Global burden of osteoporosis in knee osteoarthritis: A multicenter analysis of 32,000 patients from 15 countries. Osteoarthritis Cartilage. 33:411–428. 2025.

Tanaka K, Zhang L, Kim M, Nguyen T, Wong ML, Chen W, Patel J, Johnson DA and Saito H: Vitamin D deficiency and osteoporosis risk in Asian KOA populations: Substudy of KOA-OP global consortium. J Bone Miner Res. 32:409–425. 2025.

Du X, Liu ZY, Tao XX, Mei YL, Zhou DQ, Cheng K, Gao SL, Shi HY, Song C and Zhang XM: Research progress on the pathogenesis of knee osteoarthritis. Orthop Surg. 15:2213–2224. 2023. View Article : Google Scholar : PubMed/NCBI

Rizzoli R, Reginster JY, Bruyère O, Cooper C, Kanis JA, Al-Daghri N, Brandi ML, Cavalier E and Sambrook PN: Role of vitamin D and calcium supplementation in the management of osteoporosis: An evidence-based consensus. Aging Clin Exp Res. 32:1873–1887. 2020.

Neptune E, Kraus VB, Sharma L, Guermazi A, Roemer F, Nevitt M, Torner J, Felson D, Lewis CE, Lynch J, et al: MRI-based cartilage thickness loss predicts knee replacement within 5 years: A longitudinal analysis from the Osteoarthritis Initiative. Ann Rheum Dis. 81:331–338. 2022.

Kawaguchi H, Tanaka S, Yoshimura N, Muraki S, Akune T, Nishimura Y, Oka H, Nakamura K, Cooper CB, Sowers MF, et al: The biomechanical-metabolic paradox in coexisting osteoporosis and knee osteoarthritis. J Clin Endocrinol Metab. 108:e678–e689. 2023.

Wilson DR, Baker EL, Chen CX, Fritz MJ, Phillips LS, Schwartz AV, Smith KE and York JD: Polygenic risk score combines with EHR imaging to predict TKA: A machine learning framework. Nat Med. 29:978–989. 2023.

Li M, Zhang ZL, Xia WB, Lin H, Cheng XG, Li YZ, Xie ZJ, Wang L, Xu YJ and Liu Y: Prevalence and risk factors of osteoporosis in patients with knee osteoarthritis: A multicenter registry study. Chin J Orthop. 42:1001–1008. 2022.

Rousseau MC, Feydy A, Boutron I, Chapurlat R, Bousson V, Vital JM, Beaudoin C, Rannou F, Arden N, Maggi S, et al: Longitudinal association between knee osteoarthritis progression and bone mineral density loss: Results from the French OSTEOLAR cohort. Osteoarthritis Cartilage. 32:621–632. 2024.

Luyten FP, Kraus VB, Guermazi A, Arden NK, Bierma-Zeinstra S, Pelletier JP, Hazes J, Lohmander S, Hunter D, Kloppenburg M, et al: ROBUST-Knee: A prospective multicenter registry for biomarker discovery in knee osteoarthritis. Ann Rheum Dis. 82:1557–1567. 2023.

Zhao J, Yang W, Liang G, Luo M, Pan J, Liu J and Zeng L: The efficacy and safety of Jinwu Gutong capsule in the treatment of knee osteoarthritis: A meta-analysis of randomized controlled trials. J Ethnopharmacol. 293:1152472022. View Article : Google Scholar : PubMed/NCBI

Xiao PL, Hsu CJ, Ma YG, Liu D, Peng R, Xu XH and Lu HD: Prevalence and treatment rate of osteoporosis in patients undergoing total knee and hip arthroplasty: A systematic review and meta-analysis. Arch Osteoporos. 17:162022. View Article : Google Scholar : PubMed/NCBI

Ozen G, Kamen DL, Mikuls TR, England BR, Wolfe F and Michaud K: Trends and determinants of osteoporosis treatment and screening in patients with rheumatoid arthritis compared to osteoarthritis. Arthritis Care Res (Hoboken). 70:713–723. 2018. View Article : Google Scholar

Vuori IM: Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc. 33(6 Suppl): S551–S86. 2001. View Article : Google Scholar : PubMed/NCBI

Ma R, Wu M, Li Y, Wang J, Yang P, Chen Y, Wang W, Song J and Wang K: The use of bone turnover markers for monitoring the treatment of osteoporosis in postmenopausal females undergoing total knee arthroplasty: A prospective randomized study. J Orthop Surg Res. 16:1952021. View Article : Google Scholar : PubMed/NCBI

Jeyaraman M, Muthu S, Shehabaz S, Jeyaraman N, Rajendran RL, Hong CM, Nallakumarasamy A, Packkyarathinam RP, Sharma S, Ranjan R, et al: Current understanding of MSC-derived exosomes in the management of knee osteoarthritis. Exp Cell Res. 418:1132742022. View Article : Google Scholar : PubMed/NCBI

Yang Y, Yuan L, Cao H, Guo J, Zhou X and Zeng Z: Application and molecular mechanisms of extracellular vesicles derived from mesenchymal stem cells in osteoporosis. Curr Issues Mol Biol. 44:6346–6367. 2022. View Article : Google Scholar : PubMed/NCBI

Zhang M, Xu X, Su L, Zeng Y, Lin J, Li W, Zou Y, Li S, Lin B, Li Z, et al: Oral administration of Sophora Flavescens-derived exosomes-like nanovesicles carrying CX5461 ameliorates DSS-induced colitis in mice. J Nanobiotechnology. 22:6072024. View Article : Google Scholar : PubMed/NCBI

He X, Wang Y, Liu Z, Weng Y, Chen S, Pan Q, Li Y, Wang H, Lin S and Yu H: Osteoporosis treatment using stem cell-derived exosomes: A systematic review and meta-analysis of preclinical studies. Stem Cell Res Ther. 14:722023. View Article : Google Scholar : PubMed/NCBI

Yu L, Sui B, Fan W, Lei L, Zhou L, Yang L, Diao Y, Zhang Y, Li Z, Liu J and Hao X: Exosomes derived from osteogenic tumor activate osteoclast differentiation and concurrently inhibit osteogenesis by transferring COL1A1-targeting miRNA-92a-1-5p. J Extracell Vesicles. 10:e120562021. View Article : Google Scholar : PubMed/NCBI

Hadvina R, Lotfy Khaled M, Akoto T, Zhi W, Karamichos D and Liu Y: Exosomes and their miRNA/protein profile in keratoconus-derived corneal stromal cells. Exp Eye Res. 236:1096422023. View Article : Google Scholar : PubMed/NCBI

Kang Y, Xu C, Meng L, Dong X, Qi M and Jiang D: Exosome-functionalized magnesium-organic framework-based scaffolds with osteogenic, angiogenic and anti-inflammatory properties for accelerated bone regeneration. Bioact Mater. 18:26–41. 2022.PubMed/NCBI

He L, He T, Xing J, Zhou Q, Fan L, Liu C, Chen Y, Wu D, Tian Z, Liu B and Rong L: Bone marrow mesenchymal stem cell-derived exosomes protect cartilage damage and relieve knee osteoarthritis pain in a rat model of osteoarthritis. Stem Cell Res Ther. 11:2762020. View Article : Google Scholar : PubMed/NCBI

Sun Y, Chen P and Zhao B: Role of extracellular vesicles associated with microRNAs and their interplay with cuproptosis in osteoporosis. Noncoding RNA Res. 9:715–719. 2024. View Article : Google Scholar : PubMed/NCBI

Lou G, Chen Z, Zheng M and Liu Y: Mesenchymal stem cell-derived exosomes as a new therapeutic strategy for liver diseases. Exp Mol Med. 49:e3462017. View Article : Google Scholar : PubMed/NCBI

Zhou Q, Wei S, Wang H, Li Y, Fan S, Cao Y and Wang C: T cell-derived exosomes in tumor immune modulation and immunotherapy. Front Immunol. 14:11300332023. View Article : Google Scholar : PubMed/NCBI

Bouchareychas L, Duong P, Covarrubias S, Alsop E, Phu TA, Chung A, Gomes M, Wong D, Meechoovet B, Capili A, et al: Macrophage exosomes resolve atherosclerosis by regulating hematopoiesis and inflammation via MicroRNA cargo. Cell Rep. 32:1078812020. View Article : Google Scholar : PubMed/NCBI

Tienda-Vázquez MA, Hanel JM, Márquez-Arteaga EM, Salgado-Álvarez AP, Scheckhuber CQ, Alanis-Gómez JR, Espinoza-Silva JI, Ramos-Kuri M, Hernández-Rosas F, Melchor-Martínez EM and Parra-Saldívar R: Exosomes: A promising strategy for repair, regeneration and treatment of skin disorders. Cells. 12:16252023. View Article : Google Scholar : PubMed/NCBI

Pegtel DM and Gould SJ: Exosomes. Annu Rev Biochem. 88:487–514. 2019. View Article : Google Scholar : PubMed/NCBI

Chu DT, Phuong TNT, Tien NLB, Tran DK, Thanh VV, Quang TL, Truong DT, Pham VH, Ngoc VTN, Chu-Dinh T and Kushekhar K: An update on the progress of isolation, culture, storage, and clinical application of human bone marrow mesenchymal stem/stromal cells. Int J Mol Sci. 21:7082020. View Article : Google Scholar : PubMed/NCBI

Galipeau J and Sensébé L: Mesenchymal stromal cells: Clinical challenges and therapeutic opportunities. Cell Stem Cell. 22:824–833. 2018. View Article : Google Scholar : PubMed/NCBI

Qin C, Bai L, Li Y and Wang K: The functional mechanism of bone marrow-derived mesenchymal stem cells in the treatment of animal models with Alzheimer's disease: Crosstalk between autophagy and apoptosis. Stem Cell Res Ther. 13:902022. View Article : Google Scholar : PubMed/NCBI

Wang ZG, He ZY, Liang S, Yang Q, Cheng P and Chen AM: Comprehensive proteomic analysis of exosomes derived from human bone marrow, adipose tissue, and umbilical cord mesenchymal stem cells. Stem Cell Res Ther. 11:5112020. View Article : Google Scholar : PubMed/NCBI

Li X, Wang M, Jing X, Guo W, Hao C, Zhang Y, Gao S, Chen M, Zhang Z, Zhang X, et al: Bone Marrow- and adipose Tissue-derived mesenchymal stem cells: Characterization, differentiation, and applications in cartilage tissue engineering. Crit Rev Eukaryot Gene Expr. 28:285–310. 2018. View Article : Google Scholar : PubMed/NCBI

Zhu X, Xu X, Shen M, Wang Y, Zheng T, Li H, Wang X and Meng J: Transcriptomic heterogeneity of human mesenchymal stem cells derived from bone marrow, dental pulp, adipose tissue, and umbilical cord. Cell Reprogram. 25:162–170. 2023. View Article : Google Scholar : PubMed/NCBI

Naji A, Eitoku M, Favier B, Deschaseaux F, Rouas-Freiss N and Suganuma N: Biological functions of mesenchymal stem cells and clinical implications. Cell Mol Life Sci. 76:3323–3348. 2019. View Article : Google Scholar : PubMed/NCBI

Varzideh F, Gambardella J, Kansakar U, Jankauskas SS and Santulli G: Molecular mechanisms underlying pluripotency and Self-renewal of embryonic stem cells. Int J Mol Sci. 24:83862023. View Article : Google Scholar : PubMed/NCBI

Li Y, Guo X, Yao H, Zhang Z and Zhao H: Epigenetic control of dental stem cells: Progress and prospects in multidirectional differentiation. Epigenetics Chromatin. 17:372024. View Article : Google Scholar : PubMed/NCBI

Dong L, Li X, Leng W, Guo Z, Cai T, Ji X, Xu C, Zhu Z and Lin J: Adipose stem cells in tissue regeneration and repair: From bench to bedside. Regen Ther. 24:547–560. 2023. View Article : Google Scholar : PubMed/NCBI

Li N, Gao J, Mi L, Zhang G, Zhang L, Zhang N, Huo R, Hu J and Xu K: Synovial membrane mesenchymal stem cells: Past life, current situation, and application in bone and joint diseases. Stem Cell Res Ther. 11:3812020. View Article : Google Scholar : PubMed/NCBI

Wang Y, Fang J, Liu B, Shao C and Shi Y: Reciprocal regulation of mesenchymal stem cells and immune responses. Cell Stem Cell. 29:1515–1530. 2022. View Article : Google Scholar : PubMed/NCBI

Jiang L, Dong H, Cao H, Ji X, Luan S and Liu J: Exosomes in pathogenesis, diagnosis, and treatment of Alzheimer's disease. Med Sci Monit. 25:3329–3335. 2019. View Article : Google Scholar : PubMed/NCBI

Gonda A, Kabagwira J, Senthil GN and Wall NR: Internalization of exosomes through Receptor-mediated endocytosis. Mol Cancer Res. 17:337–347. 2019. View Article : Google Scholar

Krylova SV and Feng D: The machinery of exosomes: Biogenesis, release, and uptake. Int J Mol Sci. 24:13372023. View Article : Google Scholar : PubMed/NCBI

Tan F, Li X, Wang Z, Li J, Shahzad K and Zheng J: Clinical applications of stem cell-derived exosomes. Signal Transduct Target Ther. 9:172024. View Article : Google Scholar : PubMed/NCBI

Nishiyama Y, Ohmichi T, Kazami S, Iwasaki H, Mano K, Nagumo Y, Kudo F, Ichikawa S, Iwabuchi Y, Kanoh N, et al: Vicenistatin induces early Endosome-derived vacuole formation in mammalian cells. Biosci Biotechnol Biochem. 80:902–910. 2016. View Article : Google Scholar : PubMed/NCBI

Scott CC, Vacca F and Gruenberg J: Endosome maturation transport and functions. Semin Cell Dev Biol. 31:2–10. 2014. View Article : Google Scholar : PubMed/NCBI

Hessvik NP and Llorente A: Current knowledge on exosome biogenesis and release. Cell Mol Life Sci. 75:193–208. 2018. View Article : Google Scholar :

He C, Zheng S, Luo Y and Wang B: Exosome theranostics: Biology and translational medicine. Theranostics. 8:237–255. 2018. View Article : Google Scholar : PubMed/NCBI

Liu D, Zhao X, Zhang Q, Zhou F and Tong X: Bone marrow mesenchymal stem cell-derived exosomes promote osteoblast proliferation, migration and inhibit apoptosis by regulating KLF3-AS1/miR-338-3p. BMC Musculoskelet Disord. 25:1222024. View Article : Google Scholar : PubMed/NCBI

Huang Y, Zhang X, Zhan J, Yan Z, Chen D, Xue X and Pan X: Bone marrow mesenchymal stem cell-derived exosomal miR-206 promotes osteoblast proliferation and differentiation in osteoarthritis by reducing Elf3. J Cell Mol Med. 25:7734–7745. 2021. View Article : Google Scholar : PubMed/NCBI

Li Z, Zhang B, Shang J, Wang Y, Jia L, She X, Xu X, Zhang D, Guo J and Zhang F: Diabetic and nondiabetic BMSC-derived exosomes affect bone regeneration via regulating miR-17-5p/SMAD7 axis. Int Immunopharmacol. 125:1111902023. View Article : Google Scholar : PubMed/NCBI

Su H, Yang Y, Lv W, Li X and Zhao B: Bone marrow mesenchymal stem cell-derived exosomal microRNA-382 promotes osteogenesis in osteoblast via regulation of SLIT2. J Orthop Surg Res. 18:1852023. View Article : Google Scholar : PubMed/NCBI

Yan L, Liu G and Wu X: The umbilical cord mesenchymal stem cell-derived exosomal lncRNA H19 improves osteochondral activity through miR-29b-3p/FoxO3 axis. Clin Transl Med. 11:e2552021. View Article : Google Scholar : PubMed/NCBI

Zhang S, Lu C, Zheng S and Hong G: Hydrogel loaded with bone marrow stromal cell-derived exosomes promotes bone regeneration by inhibiting inflammatory responses and angiogenesis. World J Stem Cells. 16:499–511. 2024. View Article : Google Scholar : PubMed/NCBI

Qi X, Zhang J, Yuan H, Xu Z, Li Q, Niu X, Hu B, Wang Y and Li X: Exosomes secreted by Human-induced pluripotent stem cell-derived mesenchymal stem cells repair critical-sized bone defects through enhanced angiogenesis and osteogenesis in osteoporotic rats. Int J Biol Sci. 12:836–849. 2016. View Article : Google Scholar : PubMed/NCBI

Jiang Y, Zhang J, Li Z and Jia G: Bone marrow mesenchymal stem Cell-derived exosomal miR-25 regulates the ubiquitination and degradation of Runx2 by SMURF1 to promote fracture healing in mice. Front Med (Lausanne). 7:5775782020. View Article : Google Scholar

Yu H, Zhang J, Liu X and Li Y: microRNA-136-5p from bone marrow mesenchymal stem cell-derived exosomes facilitates fracture healing by targeting LRP4 to activate the Wnt/β-catenin pathway. Bone Joint Res. 10:744–758. 2021. View Article : Google Scholar : PubMed/NCBI

Tang Y, Sun Y, Zeng J, Yuan B, Zhao Y, Geng X, Jia L, Zhou S and Chen X: Exosomal miR-140-5p inhibits osteogenesis by targeting IGF1R and regulating the mTOR pathway in ossification of the posterior longitudinal ligament. J Nanobiotechnol. 20:4522022. View Article : Google Scholar

Lu H, Zhang Z, Wang Z, Wang J, Mi T, Jin L, Wu X, Luo J, Liu Y, Liu J, et al: Human mesenchymal stem Cells-derived exosome mimetic vesicles regulation of the MAPK pathway and ROS levels inhibits Glucocorticoid-induced apoptosis in osteoblasts. Stem Cells Int. 2023:55376102023. View Article : Google Scholar : PubMed/NCBI

Hu H, Wang D, Li L, Yin H, He G and Zhang Y: Role of microRNA-335 carried by bone marrow mesenchymal stem cells-derived extracellular vesicles in bone fracture recovery. Cell Death Dis. 12:1562021. View Article : Google Scholar : PubMed/NCBI

Lu GD, Cheng P, Liu T and Wang Z: BMSC-derived exosomal miR-29a promotes angiogenesis and osteogenesis. Front Cell Dev Biol. 8:6085212020. View Article : Google Scholar : PubMed/NCBI

Jia D, Li Y, Han R, Wang K, Cai G, He C and Yang L: miR-146a-5p expression is upregulated by the CXCR4 antagonist TN14003 and attenuates SDF-1-induced cartilage degradation. Mol Med Rep. 19:4388–4400. 2019.PubMed/NCBI

Wang X and Thomsen P: Mesenchymal stem cell-derived small extracellular vesicles and bone regeneration. Basic Clin Pharmacol Toxicol. 128:18–36. 2021. View Article : Google Scholar

Nicolini A, Ferrari P and Biava PM: Exosomes and cell communication: From Tumour-derived exosomes and their role in tumour progression to the use of exosomal cargo for cancer treatment. Cancers (Basel). 13:8222021. View Article : Google Scholar : PubMed/NCBI

Asgarpour K, Shojaei Z, Amiri F, Ai J, Mahjoubin-Tehran M, Ghasemi F, ArefNezhad R, Hamblin MR and Mirzaei H: Exosomal microRNAs derived from mesenchymal stem cells: Cell-to-cell messages. Cell Commun Signal. 18:1492020. View Article : Google Scholar : PubMed/NCBI

Cui Y, Guo Y, Kong L, Shi J, Liu P, Li R, Geng Y, Gao W, Zhang Z and Fu D: A bone-targeted engineered exosome platform delivering siRNA to treat osteoporosis. Bioact Mater. 10:207–221. 2021.PubMed/NCBI

Shen Z, Huang W, Liu J, Tian J, Wang S and Rui K: Effects of mesenchymal stem Cell-derived exosomes on autoimmune diseases. Front Immunol. 12:7491922021. View Article : Google Scholar : PubMed/NCBI

Xie QH, Zheng JQ, Ding JY, Wu YF, Liu L, Yu ZL and Chen G: Exosome-mediated immunosuppression in tumor microenvironments. Cells. 11:19462022. View Article : Google Scholar : PubMed/NCBI

Shahir M, Mahmoud Hashemi S, Asadirad A, Varahram M, Kazempour-Dizaji M, Folkerts G, Garssen J, Adcock I and Mortaz E: Effect of mesenchymal stem cell-derived exosomes on the induction of mouse tolerogenic dendritic cells. J Cell Physiol. 235:7043–7055. 2020. View Article : Google Scholar : PubMed/NCBI

Bolandi Z, Mokhberian N, Eftekhary M, Sharifi K, Soudi S, Ghanbarian H and Hashemi SM: Adipose derived mesenchymal stem cell exosomes loaded with miR-10a promote the differentiation of Th17 and Treg from naive CD4+ T cell. Life Sci. 259:1182182020. View Article : Google Scholar

Tavasolian F, Hosseini AZ, Rashidi M, Soudi S, Abdollahi E, Momtazi-Borojeni AA, Sathyapalan T and Sahebkar A: The impact of immune cell-derived exosomes on immune response initiation and immune system function. Curr Pharm Des. 27:197–205. 2021. View Article : Google Scholar

Yu J, Xue J, Liu C, Zhang A, Qin L, Liu J and Yang Y: MiR-146a-5p accelerates sepsis through dendritic cell activation and glycolysis via targeting ATG7. J Biochem Mol Toxicol. 36:e231512022. View Article : Google Scholar : PubMed/NCBI

Sun W, Yan S, Yang C, Yang J, Wang H, Li C, Zhang L, Zhao L, Zhang J, Cheng M, et al: Mesenchymal stem Cells-derived exosomes ameliorate lupus by inducing M2 macrophage polarization and regulatory T cell expansion in MRL/lpr mice. Immunol Invest. 51:1785–1803. 2022. View Article : Google Scholar : PubMed/NCBI

Khare D, Or R, Resnick I, Barkatz C, Almogi-Hazan O and Avni B: Mesenchymal stromal Cell-derived exosomes Affect mRNA expression and function of B-lymphocytes. Front Immunol. 9:30532018. View Article : Google Scholar

Wang R and Xu B: TGF-β1-modified MSC-derived exosomal miR-135b attenuates cartilage injury via promoting M2 synovial macrophage polarization by targeting MAPK6. Cell Tissue Res. 384:113–127. 2021. View Article : Google Scholar : PubMed/NCBI

Li H, Zhang P, Lin M, Li K, Zhang C, He X and Gao K: Pyroptosis: Candidate key targets for mesenchymal stem cell-derived exosomes for the treatment of Bone-related diseases. Stem Cell Res Ther. 16:682025. View Article : Google Scholar : PubMed/NCBI

Bhaskara M, Anjorin O and Wang M: Mesenchymal stem Cell-derived exosomal microRNAs in cardiac regeneration. Cells. 12:28152023. View Article : Google Scholar : PubMed/NCBI

Li J, Deng X, Ji X, Shi X, Ying Z, Shen K, Xu D and Cheng Z: Mesenchymal stem cell exosomes reverse acute lung injury through Nrf-2/ARE and NF-κB signaling pathways. PeerJ. 8:e99282020. View Article : Google Scholar

Hu Y, Qu H, He J, Zhong H, He S, Zhao P, Zhang L, Chen J and Deng C: Human placental mesenchymal stem cell derived exosomes exhibit anti-inflammatory effects via TLR4-mediated NF-κB/MAPK and PI3K signaling pathways. Pharmazie. 77:112–117. 2022.PubMed/NCBI

Liu L, Wu Y, Wang P, Shi M, Wang J, Ma H and Sun D: PSC-MSC-Derived exosomes protect against kidney fibrosis in vivo and in vitro through the SIRT6/β-catenin signaling pathway. Int J Stem Cells. 14:310–319. 2021. View Article : Google Scholar : PubMed/NCBI

Sevimli M, Inan U, Seyidova N, Guluzade L, Ahmadova Z, Gulec K, Topal AE and Semerci Sevimli T: In vitro chondrogenic induction promotes the expression level of IL-10 via the TGF-β/SMAD and Canonical Wnt/β-catenin signaling pathways in exosomes secreted by human adipose Tissue-derived mesenchymal stem cells. Cell Biochem Biophys. 82:3741–3750. 2024. View Article : Google Scholar

Zhao B, Li J, Zhang X, Dai Y, Yang N, Bao Z, Chen Y and Wu X: Exosomal miRNA-181a-5p from the cells of the hair follicle dermal papilla promotes the hair follicle growth and development via the Wnt/β-catenin signaling pathway. Int J Biol Macromol. 207:110–120. 2022. View Article : Google Scholar : PubMed/NCBI

Wang R and Xu B: TGFβ1-modified MSC-derived exosome attenuates osteoarthritis by inhibiting PDGF-BB secretion and H-type vessel activity in the subchondral bone. Acta Histochem. 124:1519332022. View Article : Google Scholar

Zhang Y, Xie Y, Hao Z, Zhou P, Wang P, Fang S, Li L, Xu S and Xia Y: Umbilical mesenchymal stem Cell-derived Exosome-encapsulated hydrogels accelerate bone repair by enhancing angiogenesis. ACS Appl Mater Interfaces. 13:18472–18487. 2021. View Article : Google Scholar : PubMed/NCBI

Zhang J, Liu X, Li H, Chen C, Hu B, Niu X, Li Q, Zhao B, Xie Z and Wang Y: Exosomes/tricalcium phosphate combination scaffolds can enhance bone regeneration by activating the PI3K/Akt signaling pathway. Stem Cell Res Ther. 7:1362016. View Article : Google Scholar : PubMed/NCBI

Zhang S, Chuah SJ, Lai RC, Hui JHP, Lim SK and Toh WS: MSC exosomes mediate cartilage repair by enhancing proliferation, attenuating apoptosis and modulating immune reactivity. Biomaterials. 156:16–27. 2018. View Article : Google Scholar

Chen JY, Feng L, Zhang HL, Li JC, Yang XW, Cao XL, Liu L, Qin HY, Liang YM and Han H: Differential regulation of bone marrow-derived endothelial progenitor cells and endothelial outgrowth cells by the Notch signaling pathway. PLoS One. 7:e436432012. View Article : Google Scholar : PubMed/NCBI

Simon TM and Jackson DW: Articular cartilage: Injury pathways and treatment options. Sports Med Arthrosc Rev. 26:31–39. 2018. View Article : Google Scholar : PubMed/NCBI

Yu Y and Zhao J: Modulated autophagy by MicroRNAs in osteoarthritis chondrocytes. Biomed Res Int. 2019:14841522019. View Article : Google Scholar : PubMed/NCBI

Kan HS, Chan PK, Chiu KY, Yan CH, Yeung SS, Ng YL, Shiu KW and Ho T: Nonsurgical treatment of knee osteoarthritis. Hong Kong Med J. 25:127–133. 2019.PubMed/NCBI

Schulze-Tanzil G: Intraarticular ligament degeneration is interrelated with cartilage and bone destruction in osteoarthritis. Cells. 8:9902019. View Article : Google Scholar : PubMed/NCBI

Zhao Z, Bi B, Cheng G, Zhao Y, Wu H, Zheng M and Cao Z: Melatonin ameliorates osteoarthritis rat cartilage injury by inhibiting matrix metalloproteinases and JAK2/STAT3 signaling pathway. Inflammopharmacology. 31:359–368. 2023. View Article : Google Scholar

Kuchynsky K, Stevens P, Hite A, Xie W, Diop K, Tang S, Pietrzak M, Khan S, Walter B and Purmessur D: Transcriptional profiling of human cartilage endplate cells identifies novel genes and cell clusters underlying degenerated and non-degenerated phenotypes. Arthritis Res Ther. 26:122024. View Article : Google Scholar : PubMed/NCBI

Radenska-Lopovok SG: Immunomorphological characteristics of the synovial membrane in rheumatic diseases. Arkh Patol. 78:64–68. 2016. View Article : Google Scholar : PubMed/NCBI

Shakoor D, Demehri S, Roemer FW, Loeuille D, Felson DT and Guermazi A: Are contrast-enhanced and non-contrast MRI findings reflecting synovial inflammation in knee osteoarthritis: A meta-analysis of observational studies. Osteoarthritis Cartilage. 28:126–136. 2020. View Article : Google Scholar

Sanchez-Lopez E, Coras R, Torres A, Lane NE and Guma M: Synovial inflammation in osteoarthritis progression. Nat Rev Rheumatol. 18:258–275. 2022. View Article : Google Scholar : PubMed/NCBI

Alivernini S, MacDonald L, Elmesmari A, Finlay S, Tolusso B, Gigante MR, Petricca L, Di Mario C, Bui L, Perniola S, et al: Distinct synovial tissue macrophage subsets regulate inflammation and remission in rheumatoid arthritis. Nat Med. 26:1295–1306. 2020. View Article : Google Scholar : PubMed/NCBI

Sanchez-Lopez E, Coras R, Torres A, Lane NE and Guma M: Synovial inflammation in osteoarthritis progression. Nat Rev Rheumatol. 18:258–275. 2022. View Article : Google Scholar : PubMed/NCBI

Harris AB, Lantieri MA, Agarwal AR, Golladay GJ and Thakkar SC: Osteoporosis and total knee arthroplasty: Higher 5-year Implant-Related complications. J Arthroplasty. 39:948–953.e1. 2024. View Article : Google Scholar

Iizawa N, Oshima Y, Kataoka T, Watanabe H, Majima T and Takai S: Relationship between severity of varus osteoarthritis of the knee and contracture of medial structures. J Nippon Med Sch. 89:108–113. 2022. View Article : Google Scholar

Roemer FW, Jarraya M, Collins JE, Kwoh CK, Hayashi D, Hunter DJ and Guermazi A: tructural phenotypes of knee osteoarthritis: Potential clinical and research relevance. Skeletal Radiol. 52:2021–2030. 2023. View Article : Google Scholar

Chen X, Wang Z, Duan N, Zhu G, Schwarz EM and Xie C: Osteoblast-osteoclast interactions. Connect Tissue Res. 59:99–107. 2018. View Article : Google Scholar

Wang LT, Chen LR and Chen KH: Hormone-related and Drug-induced osteoporosis: A cellular and molecular overview. Int J Mol Sci. 24:58142023. View Article : Google Scholar : PubMed/NCBI

Xie Y, Zhou J, Tian L, Dong Y, Yuan H, Zhu E, Li X and Wang B: miR-196b-5p regulates osteoblast and osteoclast differentiation and bone homeostasis by targeting SEMA3A. J Bone Miner Res. 38:1175–1191. 2023. View Article : Google Scholar : PubMed/NCBI

Zhao G, Luo WD, Yuan Y, Lin F, Guo LM, Ma JJ, Chen HB, Tang H and Shu J: LINC02381, a sponge of miR-21, weakens osteogenic differentiation of hUC-MSCs through KLF12-mediated Wnt4 transcriptional repression. J Bone Miner Metab. 40:66–80. 2022. View Article : Google Scholar

Brown JP: Long-term treatment of postmenopausal osteoporosis. Endocrinol Metab (Seoul). 36:544–552. 2021. View Article : Google Scholar : PubMed/NCBI

Kimmel DB, Vennin S, Desyatova A, Turner JA, Akhter MP, Lappe JM and Recker RR: Bone architecture, bone material properties, and bone turnover in nonosteoporotic postmenopausal women with fragility fracture. Osteoporos Int. 33:1125–1136. 2022. View Article : Google Scholar : PubMed/NCBI

Jonasson G and Rythén M: Alveolar bone loss in osteoporosis: A loaded and cellular affair? Clin Cosmet Investig Dent. 8:95–103. 2016. View Article : Google Scholar : PubMed/NCBI

Gorwa J, Zieliński J, Wolański W, Michnik R, Larysz D, Dworak LB and Kusy K: Decreased bone mineral density in forearm vs loaded skeletal sites in professional ballet dancers. Med Probl Perform Art. 34:25–32. 2019. View Article : Google Scholar : PubMed/NCBI

Whyne CM, Ferguson D, Clement A, Rangrez M and Hardisty M: Biomechanical properties of metastatically involved osteolytic bone. Curr Osteoporos Rep. 18:705–715. 2020. View Article : Google Scholar : PubMed/NCBI

Wu H, Yin G, Pu X, Wang J, Liao X and Huang Z: Coordination of osteoblastogenesis and osteoclastogenesis by the bone marrow mesenchymal stem Cell-derived extracellular matrix to promote bone regeneration. ACS Appl Bio Mater. 5:2913–2927. 2022. View Article : Google Scholar : PubMed/NCBI

Levin VA, Jiang X and Kagan R: Estrogen therapy for osteoporosis in the modern era. Osteoporos Int. 29:1049–1055. 2018. View Article : Google Scholar : PubMed/NCBI

Chen T, Wang Y, Hao Z, Hu Y and Li J: Parathyroid hormone and its related peptides in bone metabolism. Biochem Pharmacol. 192:1146692021. View Article : Google Scholar : PubMed/NCBI

Fang J, Zhang X, Chen X, Wang Z, Zheng S, Cheng Y, Liu S and Hao L: The role of insulin-like growth factor-1 in bone remodeling: A review. Int J Biol Macromol. 238:1241252023. View Article : Google Scholar : PubMed/NCBI

Kong Q, Gao S, Li P, Sun H, Zhang Z, Yu X, Deng F and Wang T: Calcitonin gene-related peptide-modulated macrophage phenotypic alteration regulates angiogenesis in early bone healing. Int Immunopharmacol. 130:1117662024. View Article : Google Scholar : PubMed/NCBI

Che Ahmad Tantowi NA, Lau SF and Mohamed S: Ficus deltoidea prevented bone loss in preclinical Osteoporosis/osteoarthritis model by suppressing inflammation. Calcif Tissue Int. 103:388–399. 2018. View Article : Google Scholar : PubMed/NCBI

Warmink K, Rios JL, van Valkengoed DR, Korthagen NM and Weinans H: Sprague dawley rats show more severe bone loss, osteophytosis and inflammation compared towistar han rats in a high-Fat, High-sucrose diet model of joint damage. Int J Mol Sci. 23:37252022. View Article : Google Scholar : PubMed/NCBI

Watanabe S, Matsushita T, Nishida K, Nagai K, Hoshino Y, Matsumoto T and Kuroda R: Knee osteotomy decreases joint inflammation based on synovial histology and synovial fluid analysis. Arthroscopy. 40:830–843. 2024. View Article : Google Scholar

Yuce P, Hosgor H, Rencber SF and Yazir Y: Effects of Intra-articular resveratrol injections on cartilage destruction and synovial inflammation in experimental temporomandibular joint osteoarthritis. J Oral Maxillofac Surg. 79:344.e1–344.e12. 2021. View Article : Google Scholar

Iantomasi T, Romagnoli C, Palmini G, Donati S, Falsetti I, Miglietta F, Aurilia C, Marini F, Giusti F and Brandi ML: Oxidative stress and inflammation in osteoporosis: Molecular mechanisms involved and the relationship with microRNAs. Int J Mol Sci. 24:37722023. View Article : Google Scholar : PubMed/NCBI

Bai RJ, Li YS and Zhang FJ: Osteopontin, a bridge links osteoarthritis and osteoporosis. Front Endocrinol (Lausanne). 13:10125082022. View Article : Google Scholar : PubMed/NCBI

Aubonnet R, Ramos J, Recenti M, Jacob D, Ciliberti F, Guerrini L, Gislason MK, Sigurjonsson O, Tsirilaki M, Jónsson H Jr and Gargiulo P: Toward new assessment of knee cartilage degeneration. Cartilage. 14:351–374. 2023. View Article : Google Scholar :

Mehana EE, Khafaga AF and El-Blehi SS: The role of matrix metalloproteinases in osteoarthritis pathogenesis: An updated review. Life Sci. 234:1167862019. View Article : Google Scholar : PubMed/NCBI

Yao Q, Wu X, Tao C, Gong W, Chen M, Qu M, Zhong Y, He T, Chen S and Xiao G: Osteoarthritis: Pathogenic signaling pathways and therapeutic targets. Signal Transduct Target Ther. 8:562023. View Article : Google Scholar : PubMed/NCBI

Mukherjee A and Das B: The role of inflammatory mediators and matrix metalloproteinases (MMPs) in the progression of osteoarthritis. Biomater Biosyst. 13:1000902024.PubMed/NCBI

Zhou Q, Ren Q, Jiao L, Huang J, Yi J, Chen J, Lai J, Ji G and Zheng T: The potential roles of JAK/STAT signaling in the progression of osteoarthritis. Front Endocrinol (Lausanne). 13:10690572022. View Article : Google Scholar : PubMed/NCBI

Fukuda K, Miura Y, Maeda T, Hayashi S, Matsumoto T and Kuroda R: Expression profiling of genes in rheumatoid fibroblast-like synoviocytes regulated by Fas ligand via cDNA microarray analysis. Exp Ther Med. 22:10002021. View Article : Google Scholar : PubMed/NCBI

Yang Y, Cheng R, Liu J, Fang J, Wang X, Cui Y, Zhang P and Du B: Linarin protects against Cadmium-induced osteoporosis via reducing oxidative stress and inflammation and altering RANK/RANKL/OPG pathway. Biol Trace Elem Res. 200:3688–3700. 2022. View Article : Google Scholar

Wang L, You X, Zhang L, Zhang C and Zou W: Mechanical regulation of bone remodeling. Bone Res. 10:162022. View Article : Google Scholar : PubMed/NCBI

Koyama Y, Tateuchi H, Araki K, Fujita K, Umehara J, Kobayashi M and Ichihashi N: Mechanical energy efficiency for stepping up and down in persons with medial knee osteoarthritis. Gait Posture. 69:143–149. 2019. View Article : Google Scholar : PubMed/NCBI

Chen L, Zhang Z and Liu X: Role and mechanism of mechanical load in the homeostasis of the subchondral bone in knee osteoarthritis: A comprehensive review. J Inflamm Res. 17:9359–9378. 2024. View Article : Google Scholar : PubMed/NCBI

Yokota S, Ishizu H, Miyazaki T, Takahashi D, Iwasaki N and Shimizu T: Osteoporosis, osteoarthritis, and subchondral insufficiency fracture: Recent insights. Biomedicines. 12:8432024. View Article : Google Scholar : PubMed/NCBI

Im GI and Kim MK: The relationship between osteoarthritis and osteoporosis. J Bone Miner Metab. 32:101–109. 2014. View Article : Google Scholar

Wada H, Aso K, Izumi M and Ikeuchi M: The effect of post-menopausal osteoporosis on subchondral bone pathology in a rat model of knee osteoarthritis. Sci Rep. 13:29262023. View Article : Google Scholar

Fujita H, Ochi M, Ono M, Aoyama E, Ogino T, Kondo Y and Ohuchi H: Glutathione accelerates osteoclast differentiation and inflammatory bone destruction. Free Radic Res. 53:226–236. 2019. View Article : Google Scholar : PubMed/NCBI

Da W, Tao L and Zhu Y: The role of osteoclast energy metabolism in the occurrence and development of osteoporosis. Front Endocrinol (Lausanne). 12:6753852021. View Article : Google Scholar : PubMed/NCBI

Li J, Zhang Z and Huang X: l-Arginine and allopurinol supplementation attenuates inflammatory mediators in human Osteoblasts-osteoarthritis cells. Int J Biol Macromol. 118:716–721. 2018. View Article : Google Scholar : PubMed/NCBI

Kovács B, Vajda E and Nagy EE: Regulatory effects and interactions of the wnt and OPG-RANKL-RANK signaling at the Bone-cartilage interface in osteoarthritis. Int J Mol Sci. 20:46532019. View Article : Google Scholar : PubMed/NCBI

Trojian T and Naik H: Arthritis: Knee and hip osteoarthritis. FP Essent. 548:6–12. 2025.PubMed/NCBI

Fujii Y, Liu L, Yagasaki L, Inotsume M, Chiba T and Asahara H: Cartilage homeostasis and osteoarthritis. Int J Mol Sci. 23:63162022. View Article : Google Scholar : PubMed/NCBI

Geng R, Li J, Yu C, Zhang C, Chen F, Chen J, Ni H, Wang J, Kang K, Wei Z, et al: Knee osteoarthritis: Current status and research progress in treatment (review). Exp Ther Med. 26:4812023. View Article : Google Scholar : PubMed/NCBI

Herrero-Beaumont G, Roman-Blas JA, Bruyère O, Cooper C, Kanis J, Maggi S, Rizzoli R and Reginster JY: Clinical settings in knee osteoarthritis: Pathophysiology guides treatment. Maturitas. 96:54–57. 2017. View Article : Google Scholar : PubMed/NCBI

Klemm P, Schulz N, Lange U and Bühring B: Diagnostics and treatment of osteoporosis in 2025: An update on current guidelines. Inn Med (Heidelb). 66:603–614. 2025.PubMed/NCBI

Boyde A: Scanning electron microscopy and bone. Methods Mol Biol. 2885:621–670. 2025. View Article : Google Scholar : PubMed/NCBI

Geusens PP and van den Bergh JP: Osteoporosis and osteoarthritis: Shared mechanisms and epidemiology. Curr Opin Rheumatol. 28:97–103. 2016. View Article : Google Scholar : PubMed/NCBI

Musyuni P, Kumar D, Pandita D, Jain GK, Nagpal M and Aggarwal G: Application of nutraceuticals in managing osteoarthritis and osteoporosis. Recent Pat Food Nutr Agric. 12:88–103. 2021. View Article : Google Scholar

Tanaka Y, Nakayamada S and Okada Y: Osteoblasts and osteoclasts in bone remodeling and inflammation. Curr Drug Targets Inflamm Allergy. 4:325–328. 2005. View Article : Google Scholar : PubMed/NCBI

Zheng H, Qu L, Yang L, Xie X, Song L and Xie Q: An injectable hydrogel loaded with Icariin attenuates cartilage damage in rabbit knee osteoarthritis via Wnt/β-catenin signaling pathway. Int Immunopharmacol. 145:1137252025. View Article : Google Scholar

Smith AE, Sigurbjörnsdóttir ES, Steingrímsson E and Sigurbjörnsdóttir S: Hedgehog signalling in bone and osteoarthritis: The role of Smoothened and cholesterol. FEBS J. 290:3059–3075. 2023. View Article : Google Scholar

Scotece M, Koskinen-Kolasa A, Pemmari A, Leppänen T, Hämäläinen M, Moilanen T, Moilanen E and Vuolteenaho K: Novel adipokine associated with OA: Retinol binding protein 4 (RBP4) is produced by cartilage and is correlated with MMPs in osteoarthritis patients. Inflamm Res. 69:415–421. 2020. View Article : Google Scholar : PubMed/NCBI

Xu F, Zhong JY, Guo B, Lin X, Wu F, Li FX, Shan SK, Zheng MH, Wang Y, Xu QS, et al: H19 promotes osteoblastic transition by acting as ceRNA of miR-140-5p in vascular smooth muscle cells. Front Cell Dev Biol. 10:7743632022. View Article : Google Scholar : PubMed/NCBI

Udagawa N, Koide M, Nakamura M, Nakamichi Y, Yamashita T, Uehara S, Kobayashi Y, Furuya Y, Yasuda H, Fukuda C and Tsuda E: Osteoclast differentiation by RANKL and OPG signaling pathways. J Bone Miner Metab. 39:19–26. 2021. View Article : Google Scholar

Nassar ES, Elnemr R, Shaaban A, Elhameed AA and Taleb RSZ: Association between AXIN1 gene polymorphism (rs9921222) of WNT signaling pathway and susceptibility to osteoporosis in Egyptian patients: A case-control study. BMC Musculoskelet Disord. 24:5272023. View Article : Google Scholar : PubMed/NCBI

Falchetti A: Genetics of osteoarticular disorders, Florence, Italy, 22-23 February 2002. Arthritis Res. 4:326–331. 2002. View Article : Google Scholar : PubMed/NCBI

Findlay DM and Atkins GJ: Osteoblast-chondrocyte interactions in osteoarthritis. Curr Osteoporos Rep. 12:127–134. 2014. View Article : Google Scholar : PubMed/NCBI

Delgado-Calle J, Fernández AF, Sainz J, Zarrabeitia MT, Sañudo C, García-Renedo R, Pérez-Núñez MI, García-Ibarbia C, Fraga MF and Riancho JA: Genome-wide profiling of bone reveals differentially methylated regions in osteoporosis and osteoarthritis. Arthritis Rheum. 65:197–205. 2013. View Article : Google Scholar

Boroňová I, Bernasovská J, Mačeková S, Petrejčíková E, Tomková Z, Kľoc J, Poráčová J, Blaščáková MM and Litavcová E: TNFRSF11B gene polymorphisms, bone mineral density, and fractures in Slovak postmenopausal women. J Appl Genet. 56:57–63. 2015. View Article : Google Scholar

Marozik P, Rudenka A, Kobets K and Rudenka E: Vitamin D status, bone mineral density, and VDR gene polymorphism in a cohort of belarusian postmenopausal women. Nutrients. 13:8372021. View Article : Google Scholar : PubMed/NCBI

Carlson KM, Yamaga KM, Reinker KA, Hsia YE, Carpenter C, Abe LM, Perry AK, Person DA, Marchuk DA and Raney EM: Precocious osteoarthritis in a family with recurrent COL2A1 mutation. J Rheumatol. 33:1133–1116. 2006.PubMed/NCBI

van der Kraan PM: Factors that influence outcome in experimental osteoarthritis. Osteoarthritis Cartilage. 25:369–375. 2017. View Article : Google Scholar

Ntanasis-Stathopoulos J, Tzanninis JG, Philippou A and Koutsilieris M: Epigenetic regulation on gene expression induced by physical exercise. J Musculoskelet Neuronal Interact. 13:133–146. 2013.PubMed/NCBI

Czogała W, Czogała M, Strojny W, Wątor G, Wołkow P, Wójcik M, Bik Multanowski M, Tomasik P, Wędrychowicz A, Kowalczyk W, et al: Methylation and expression of FTO and PLAG1 genes in childhood obesity: Insight into anthropometric parameters and Glucose-lipid metabolism. Nutrients. 13:16832021. View Article : Google Scholar

Gilbert SJ, Jones R, Egan BJ, Bonnet CS, Evans SL and Mason DJ: Investigating mechanical and inflammatory pathological mechanisms in osteoarthritis using MSC-derived osteocyte-like cells in 3D. Front Endocrinol (Lausanne). 15:13590522024. View Article : Google Scholar : PubMed/NCBI

Zhang L, Liu W, Zhao J, Ma X, Shen L, Zhang Y, Jin F and Jin Y: Mechanical stress regulates osteogenic differentiation and RANKL/OPG ratio in periodontal ligament stem cells by the Wnt/β-catenin pathway. Biochim Biophys Acta. 1860:2211–2219. 2016. View Article : Google Scholar : PubMed/NCBI

Gao YH, Zhao CW, Liu B, Dong N, Ding L, Li YR, Liu JG, Feng W, Qi X and Jin XH: An update on the association between metabolic syndrome and osteoarthritis and on the potential role of leptin in osteoarthritis. Cytokine. 129:1550432020. View Article : Google Scholar : PubMed/NCBI

Sun X, Sun B, Sammani S, Dudek SM, Belvitch P, Camp SM, Zhang D, Bime C and Garcia JGN: Genetic and epigenetic regulation of cortactin (CTTN) by inflammatory factors and mechanical stress in human lung endothelial cells. Biosci Rep. 44:BSR202319342024. View Article : Google Scholar : PubMed/NCBI

Kania K, Colella F, Riemen AHK, Wang H, Howard KA, Aigner T, Dell'Accio F, Capellini TD, Roelofs AJ and De Bari C: Regulation of Gdf5 expression in joint remodelling, repair and osteoarthritis. Sci Rep. 10:1572020. View Article : Google Scholar : PubMed/NCBI

Zhang X, Chen Y, Zhang C, Zhang X, Xia T, Han J, Song S, Xu C and Chen F: Effects of icariin on the fracture healing in young and old rats and its mechanism. Pharm Biol. 59:1245–1255. 2021. View Article : Google Scholar : PubMed/NCBI

Stathopoulou MG, Dedoussis GV, Trovas G, Katsalira A, Hammond N, Deloukas P and Lyritis GP: Low-density lipoprotein receptor-related protein 5 polymorphisms are associated with bone mineral density in Greek postmenopausal women: An interaction with calcium intake. J Am Diet Assoc. 110:1078–1083. 2010. View Article : Google Scholar : PubMed/NCBI

Tao Y, Zhou J, Wang Z, Tao H, Bai J, Ge G, Li W, Zhang W, Hao Y, Yang X and Geng D: Human bone mesenchymal stem cells-derived exosomal miRNA-361-5p alleviates osteoarthritis by downregulating DDX20 and inactivating the NF-κB signaling pathway. Bioorg Chem. 113:1049782021. View Article : Google Scholar

Qiu B, Xu X, Yi P and Hao Y: Curcumin reinforces MSC-derived exosomes in attenuating osteoarthritis via modulating the miR-124/NF-kB and miR-143/ROCK1/TLR9 signalling pathways. J Cell Mol Med. 24:10855–10865. 2020. View Article : Google Scholar : PubMed/NCBI

Lou C, Jiang H, Lin Z, Xia T, Wang W, Lin C, Zhang Z, Fu H, Iqbal S, Liu H, et al: MiR-146b-5p enriched bioinspired exosomes derived from fucoidan-directed induction mesenchymal stem cells protect chondrocytes in osteoarthritis by targeting TRAF6. J Nanobiotechnol. 21:4862023. View Article : Google Scholar

Liu Y, Lin L, Zou R, Wen C, Wang Z and Lin F: MSC-derived exosomes promote proliferation and inhibit apoptosis of chondrocytes via lncRNA-KLF3-AS1/miR-206/GIT1 axis in osteoarthritis. Cell Cycle. 17:2411–2422. 2018. View Article : Google Scholar : PubMed/NCBI

Jammes M, Cassé F, Velot E, Bianchi A, Audigié F, Contentin R and Galéra P: Pro-inflammatory cytokine priming and purification method modulate the impact of exosomes derived from equine bone marrow mesenchymal stromal cells on equine articular chondrocytes. Int J Mol Sci. 24:141692023. View Article : Google Scholar : PubMed/NCBI

Cosenza S, Ruiz M, Toupet K, Jorgensen C and Noël D: Mesenchymal stem cells derived exosomes and microparticles protect cartilage and bone from degradation in osteoarthritis. Sci Rep. 7:162142017. View Article : Google Scholar : PubMed/NCBI

Qi H, Liu DP, Xiao DW, Tian DC, Su YW and Jin SF: Exosomes derived from mesenchymal stem cells inhibit mitochondrial dysfunction-induced apoptosis of chondrocytes via p38, ERK, and Akt pathways. In Vitro Cell Dev Biol Anim. 55:203–210. 2019. View Article : Google Scholar : PubMed/NCBI

Wang Y, Yu D, Liu Z, Zhou F, Dai J, Wu B, Zhou J, Heng BC, Zou XH, Ouyang H and Liu H: Exosomes from embryonic mesenchymal stem cells alleviate osteoarthritis through balancing synthesis and degradation of cartilage extracellular matrix. Stem Cell Res Ther. 8:1892017. View Article : Google Scholar : PubMed/NCBI

Jin Z, Ren J and Qi S: Exosomal miR-9-5p secreted by bone marrow-derived mesenchymal stem cells alleviates osteoarthritis by inhibiting syndecan-1. Cell Tissue Res. 381:99–114. 2020. View Article : Google Scholar : PubMed/NCBI

Chen LQ, Ma S, Yu J, Zuo DC, Yin ZJ, Li FY, He X, Peng HT, Shi XQ, Huang WJ, et al: Human umbilical cord mesenchymal stem cell-derived exosomal miR-199a-3p inhibits the MAPK4/NF-κB signaling pathway to relieve osteoarthritis. World J Stem Cells. 17:1039192025. View Article : Google Scholar

Sotozawa M, Kumagai K, Ishikawa K, Yamada S, Inoue Y and Inaba Y: Bevacizumab suppressed degenerative changes in articular cartilage explants from patients with osteoarthritis of the knee. J Orthop Surg Res. 18:252023. View Article : Google Scholar : PubMed/NCBI

Adam MS, Zhuang H, Ren X, Zhang Y and Zhou P: The metabolic characteristics and changes of chondrocytes in vivo and in vitro in osteoarthritis. Front Endocrinol (Lausanne). 15:13935502024. View Article : Google Scholar : PubMed/NCBI

Jiang K, Jiang T, Chen Y and Mao X: Mesenchymal stem Cell-derived exosomes modulate chondrocyte glutamine metabolism to alleviate osteoarthritis progression. Mediators Inflamm. 2021:29791242021. View Article : Google Scholar

Bao C and He C: The role and therapeutic potential of MSC-derived exosomes in osteoarthritis. Arch Biochem Biophys. 710:1090022021. View Article : Google Scholar : PubMed/NCBI

Zou J, Yang W, Cui W, Li C, Ma C, Ji X, Hong J, Qu Z, Chen J, Liu A and Wu H: Therapeutic potential and mechanisms of mesenchymal stem cell-derived exosomes as bioactive materials in tendon-bone healing. J Nanobiotechnology. 21:142023. View Article : Google Scholar : PubMed/NCBI

Xie L, Chen Z, Liu M, Huang W, Zou F, Ma X, Tao J, Guo J, Xia X, Lyu F, et al: MSC-Derived exosomes protect vertebral endplate chondrocytes against apoptosis and calcification via the miR-31-5p/ATF6 axis. Mol Ther Nucleic Acids. 22:601–614. 2020. View Article : Google Scholar : PubMed/NCBI

Liu Y, Zou R, Wang Z, Wen C, Zhang F and Lin F: Exosomal KLF3-AS1 from hMSCs promoted cartilage repair and chondrocyte proliferation in osteoarthritis. Biochem J. 475:3629–3638. 2018. View Article : Google Scholar : PubMed/NCBI

Zhang Z, Zhao S, Sun Z, Zhai C, Xia J, Wen C and Zhang Y and Zhang Y: Enhancement of the therapeutic efficacy of mesenchymal stem cell-derived exosomes in osteoarthritis. Cell Mol Biol Lett. 28:752023. View Article : Google Scholar : PubMed/NCBI

Jiang S, Tian G, Yang Z, Gao X, Wang F, Li J, Tian Z, Huang B, Wei F, Sang X, et al: Enhancement of acellular cartilage matrix scaffold by Wharton's jelly mesenchymal stem cell-derived exosomes to promote osteochondral regeneration. Bioact Mater. 6:2711–2728. 2021.PubMed/NCBI

Tao SC, Yuan T, Zhang YL, Yin WJ, Guo SC and Zhang CQ: Exosomes derived from miR-140-5p-overexpressing human synovial mesenchymal stem cells enhance cartilage tissue regeneration and prevent osteoarthritis of the knee in a rat model. Theranostics. 7:180–195. 2017. View Article : Google Scholar : PubMed/NCBI

Wu M, Wu S, Chen W and Li YP: The roles and regulatory mechanisms of TGF-β and BMP signaling in bone and cartilage development, homeostasis and disease. Cell Res. 34:101–123. 2024. View Article : Google Scholar : PubMed/NCBI

Sani M, Hosseinie R, Latifi M, Shadi M, Razmkhah M, Salmannejad M, Parsaei H and Talaei-Khozani T: Engineered artificial articular cartilage made of decellularized extracellular matrix by mechanical and IGF-1 stimulation. Biomater Adv. 139:2130192022. View Article : Google Scholar : PubMed/NCBI

Löfvall H, Newbould H, Karsdal MA, Dziegiel MH, Richter J, Henriksen K and Thudium CS: Osteoclasts degrade bone and cartilage knee joint compartments through different resorption processes. Arthritis Res Ther. 20:672018. View Article : Google Scholar : PubMed/NCBI

Ma L, Liu Y, Xu F, Shen R, Wang M, Zhang Y, Liu C and Zheng G: IL-27-induced, MSC-derived exosomes promote MMP3 expression through the miR-206/L3MBTL4 axis in synovial fibroblasts. Altern Ther Health Med. 29:680–688. 2023.PubMed/NCBI

Ungsudechachai T, Honsawek S, Jittikoon J and Udomsinprasert W: Clusterin is associated with systemic and synovial inflammation in knee osteoarthritis. Cartilage. 13(1_Suppl): S1557S–S1565S. 2021. View Article : Google Scholar

Vilá S: Inflammation in osteoarthritis. P R Health Sci J. 36:123–129. 2017.PubMed/NCBI

Rosini S, Saviola G, Comini L and Molfetta L: Mesenchymal cells are a promising-But Still Unsatisfying-Anti-Inflammatory therapeutic strategy for osteoarthritis: A narrative review. Curr Rheumatol Rev. 19:287–293. 2023. View Article : Google Scholar

Qiu M, Liu D and Fu Q: MiR-129-5p shuttled by human synovial mesenchymal stem cell-derived exosomes relieves IL-1β induced osteoarthritis by targeting HMGB1. Life Sci. 269:1189872021. View Article : Google Scholar

Chen YH, Hsieh SC, Chen WY, Li KJ, Wu CH, Wu PC, Tsai CY and Yu CL: Spontaneous resolution of acute gouty arthritis is associated with rapid induction of the anti-inflammatory factors TGFβ1, IL-10 and soluble TNF receptors and the intracellular cytokine negative regulators CIS and SOCS3. Ann Rheum Dis. 70:1655–1663. 2011. View Article : Google Scholar : PubMed/NCBI

Yang J, Yang L, Tian L, Ji X, Yang L and Li L: Sphingosine 1-phosphate (S1P)/S1P Receptor2/3 axis promotes inflammatory M1 polarization of bone Marrow-Derived Monocyte/Macrophagevia G(α)i/o/PI3K/JNK pathway. Cell Physiol Biochem. 49:1677–1693. 2018. View Article : Google Scholar

Ruiz-Miyazawa KW, Staurengo-Ferrari L, Pinho-Ribeiro FA, Fattori V, Zaninelli TH, Badaro-Garcia S, Borghi SM, Andrade KC, Clemente-Napimoga JT, Alves-Filho JC, et al: 15d-PGJ₂-loaded nanocapsules ameliorate experimental gout arthritis by reducing pain and inflammation in a PPAR-gamma-sensitive manner in mice. Sci Rep. 8:139792018. View Article : Google Scholar

Hao F, Wang Q, Liu L, Wu LB, Cai RL, Sang JJ, Hu J, Wang J, Yu Q, He L, et al: Effect of moxibustion on autophagy and the inflammatory response of synovial cells in rheumatoid arthritis model rat. J Tradit Chin Med. 42:73–82. 2022.PubMed/NCBI

Xu X, Liang Y, Li X, Ouyang K, Wang M, Cao T, Li W, Liu J, Xiong J, Li B, et al: Exosome-mediated delivery of kartogenin for chondrogenesis of synovial fluid-derived mesenchymal stem cells and cartilage regeneration. Biomaterials. 269:1205392021. View Article : Google Scholar

Bruckner S, Capria VM, Zeno B, Leblebicioglu B, Goyal K, Vasileff WK, Awan H, Willis WL, Ganesan LP and Jarjour WN: The therapeutic effects of gingival mesenchymal stem cells and their exosomes in a chimeric model of rheumatoid arthritis. Arthritis Res Ther. 25:2112023. View Article : Google Scholar : PubMed/NCBI

Mathiessen A and Conaghan PG: Synovitis in osteoarthritis: Current understanding with therapeutic implications. Arthritis Res Ther. 19:182017. View Article : Google Scholar : PubMed/NCBI

Wang Y, Hou L, Yuan X, Xu N, Zhao S, Yang L and Zhang N: LncRNA NEAT1 targets Fibroblast-like synoviocytes in rheumatoid arthritis via the miR-410-3p/YY1 Axis. Front Immunol. 11:19752020. View Article : Google Scholar : PubMed/NCBI

Qiu M, Xie Y, Tan G, Wang X, Huang P and Hong L: Synovial mesenchymal stem cell-derived exosomal miR-485-3p relieves cartilage damage in osteoarthritis by targeting the NRP1-mediated PI3K/Akt pathway: Exosomal miR-485-3p relieves cartilage damage. Heliyon. 10:e240422024. View Article : Google Scholar : PubMed/NCBI

Ichise Y, Saegusa J, Tanaka-Natsui S, Naka I, Hayashi S, Kuroda R and Morinobu A: Soluble CD14 induces pro-inflammatory cytokines in rheumatoid arthritis fibroblast-like synovial cells via toll-like receptor 4. Cells. 9:16892020. View Article : Google Scholar : PubMed/NCBI

Qi H, Shen E, Shu X, Liu D and Wu C: ERK-estrogen receptor α signaling plays a role in the process of bone marrow mesenchymal stem cell-derived exosomes protecting against ovariectomy-induced bone loss. J Orthop Surg Res. 18:2502023. View Article : Google Scholar

Wei Y, Ma Z, Li Z, Kang J, Liao T, Jie L, Liu D, Shi L, Wang P, Mao J and Wu P: Gentiopicroside ameliorates synovial inflammation and fibrosis in KOA rats by modulating the HMGB1-mediated PI3K/AKT signaling axis. Int Immunopharmacol. 147:1139732025. View Article : Google Scholar : PubMed/NCBI

Meng S, Zhang X, Yu Y, Tong M, Yuan Y, Cao Y, Zhang W, Shi X and Liu K: New-QiangGuYin-containing serum inhibits osteoclast-Derived exosome secretion and down-regulates notum to promote osteoblast differentiation. Adv Biol (Weinh). 9:e24001662025. View Article : Google Scholar

Liu Z, Jian H, Peng Z, Xiong S and Zhang Z: Association between dietary inflammatory index and osteoporosis in the US population: Evidence from NHANES 2003-2010. Front Nutr. 12:15081272025. View Article : Google Scholar : PubMed/NCBI

Huang S, Wa Q, Pan J, Peng X, Ren D, Huang Y, Chen X and Tang Y: Downregulation of miR-141-3p promotes bone metastasis via activating NF-κB signaling in prostate cancer. J Exp Clin Cancer Res. 36:1732017. View Article : Google Scholar

Yang S, Zhang W, Cai M, Zhang Y, Jin F, Yan S, Baloch Z, Fang Z, Xue S, Tang R, et al: Suppression of bone resorption by miR-141 in aged rhesus monkeys. J Bone Miner Res. 33:1799–1812. 2018. View Article : Google Scholar : PubMed/NCBI

Ye Y, Li SL, Ma YY, Diao YJ, Yang L, Su MQ, Li Z, Ji Y, Wang J, Lei L, et al: Exosomal miR-141-3p regulates osteoblast activity to promote the osteoblastic metastasis of prostate cancer. Oncotarget. 8:94834–94849. 2017. View Article : Google Scholar : PubMed/NCBI

Longfei H, Wenyuan H, Weihua F, Peng P, Sun L, Kun L, Mincong H, Fan Y, Wei H and Qiushi W: Exosomes in cartilage microenvironment regulation and cartilage repair. Front Cell Dev Biol. 13:14604162025. View Article : Google Scholar : PubMed/NCBI

Helaehil JV, Huang B, Bartolo P, Santamaria M Jr and Caetano GF: Bone regeneration: The influence of composite HA/TCP scaffolds and electrical stimulation on TGF/BMP and RANK/RANKL/OPG pathways. Injury. 56:1121582025. View Article : Google Scholar : PubMed/NCBI

Hu Z, Deshmukh M, Jarneborn A, Bollmann M, Corciulo C, Kopparapu PK, Ali A, Svensson MND, Engdahl C, Pullerits R, et al: Combination treatment with anti-RANKL and antibiotics for preventing joint destruction in septic arthritis. JCI Insight. 10:e1849542025. View Article : Google Scholar : PubMed/NCBI

Kurihara T, Shimamura M, Etani Y, Noguchi T, Fukuda Y, Ochiai N, Goshima A, Miura T, Hirao M, Sugimoto A, et al: RANKL-derived peptide MHP1-AcN attenuates ovariectomy-induced osteoporosis by targeting RANK and TNFR1 in mice. Bone. 194:1174402025. View Article : Google Scholar : PubMed/NCBI

Pei B, Teng Y, Dong D and Liu L: OPG/RANK/RANKL Single-nucleotide polymorphisms in rheumatoid arthritis: Associations with disease susceptibility, bone mineral density, and clinical manifestations in a Chinese Han population. Int J Gen Med. 18:815–824. 2025. View Article : Google Scholar : PubMed/NCBI

Liao T, Kang J, Ma Z, Jie L, Feng M, Liu D, Mao J, Wang P and Xing R: Total glucosides of white paeony capsule alleviate articular cartilage degeneration and aberrant subchondral bone remodeling in knee osteoarthritis. Phytother Res. 39:1758–1775. 2025. View Article : Google Scholar

Li J, Ding Z, Li Y, Wang W, Wang J, Yu H, Liu A, Miao J, Chen S, Wu T and Cao Y: BMSCs-derived exosomes ameliorate pain via abrogation of aberrant nerve invasion in subchondral bone in lumbar facet joint osteoarthritis. J Orthop Res. 38:670–679. 2020. View Article : Google Scholar

Wei Z, Zhou J, Shen J, Sun D, Gao T, Liu Q, Wu H, Wang X, Wang S, Xiao S, et al: Osteostaticytes: A novel osteoclast subset couples bone resorption and bone formation. J Orthop Translat. 47:144–160. 2024. View Article : Google Scholar : PubMed/NCBI

Wan Y, Nemoto YL, Oikawa T, Takano K, Fujiwara TK, Tsujita K and Itoh T: Mechanical control of osteoclast fusion by Membrane-cortex attachment and BAR proteins. J Cell Biol. 224:e2024110242025. View Article : Google Scholar : PubMed/NCBI

Shao Y, Zhang H, Guan H, Wu C, Qi W, Yang L, Yin J, Zhang H, Liu L, Lu Y, et al: PDZK1 protects against mechanical overload-induced chondrocyte senescence and osteoarthritis by targeting mitochondrial function. Bone Res. 12:412024. View Article : Google Scholar : PubMed/NCBI

Chen N, Diao CY, Huang X, Tan WX, Chen YB, Qian XY, Gao J and Zhao DB: RhoA promotes synovial proliferation and bone erosion in rheumatoid arthritis through Wnt/PCP pathway. Mediators Inflamm. 2023:50570092023. View Article : Google Scholar : PubMed/NCBI

Zhang W, Wu X, Li W, Zhang H, Wang Y, Xu J, Li W, Qin Y, Wu Z, Ge G, et al: Pinosylvin inhibits inflammatory and osteoclastogenesis via NLRP3 inflammasome. Adv Sci (Weinh). e015322025. View Article : Google Scholar : Epub ahead of print. PubMed/NCBI

Cafferata EA, Monasterio G, Castillo F, Carvajal P, Flores G, Díaz W, Fuentes AD and Vernal R: Overexpression of MMPs, cytokines, and RANKL/OPG in temporomandibular joint osteoarthritis and their association with joint pain, mouth opening, and bone degeneration: A preliminary report. Oral Dis. 27:970–980. 2021. View Article : Google Scholar

Wu P, Jiao F, Huang H, Liu D, Tang W, Liang J and Chen W: Morinda officinalis polysaccharide enable suppression of osteoclastic differentiation by exosomes derived from rat mesenchymal stem cells. Pharm Biol. 60:1303–1316. 2022. View Article : Google Scholar : PubMed/NCBI

Gostage J, Kostenuik P, Goljanek-Whysall K, Bellantuono I, McCloskey E and Bonnet N: Extra-osseous roles of the RANK-RANKL-OPG axis with a focus on skeletal muscle. Curr Osteoporos Rep. 22:632–650. 2024. View Article : Google Scholar : PubMed/NCBI

Hu Y, Wang Z, Fan C, Gao P, Wang W, Xie Y and Xu Q: Human gingival mesenchymal stem cell-derived exosomes cross-regulate the Wnt/β-catenin and NF-κB signalling pathways in the periodontal inflammation microenvironment. J Clin Periodontol. 50:796–806. 2023. View Article : Google Scholar : PubMed/NCBI

Li L, Huang R, Gao X, Li Z, Lin Y, Zhang H, Jiang Y and Fan P: Prevalence of osteoporosis in patients with knee osteoarthritis awaiting total knee arthroplasty is similar to that in the general population. BMC Musculoskelet Disord. 26:2172025. View Article : Google Scholar : PubMed/NCBI

Fischer V and Haffner-Luntzer M: Interaction between bone and immune cells: Implications for postmenopausal osteoporosis. Semin Cell Dev Biol. 123:14–21. 2022. View Article : Google Scholar

Li Y, Ling J and Jiang Q: Inflammasomes in alveolar bone loss. Front Immunol. 12:6910132021. View Article : Google Scholar : PubMed/NCBI

El-Ali Z, El-Kassas G, Ziade FM, Shivappa N, Hébert JR, Zmerly H and Bissar N: Evaluation of circulating levels of Interleukin-10 and Interleukin-16 and dietary inflammatory index in Lebanese knee osteoarthritis patients. Heliyon. 7:e075512021. View Article : Google Scholar : PubMed/NCBI

Piao X, Kim JW, Hyun M, Wang Z, Park SG, Cho IA, Ryu JH, Lee BN, Song JH and Koh JT: Boeravinone B, a natural rotenoid, inhibits osteoclast differentiation through modulating NF-κB, MAPK and PI3K/Akt signaling pathways. BMB Rep. 56:545–550. 2023. View Article : Google Scholar : PubMed/NCBI

Zheng X, Qiu J, Gao N, Jiang T, Li Z, Zhang W, Gong Y, Hong Z and Hong H: Paroxetine attenuates chondrocyte pyroptosis and inhibits osteoclast formation by inhibiting NF-κB pathway activation to delay osteoarthritis progression. Drug Des Devel Ther. 17:2383–2399. 2023. View Article : Google Scholar :

Xu J, Jiao W, Wu DB, Yu JH, Liu LJ, Zhang MY and Chen GX: Yishen Tongbi decoction attenuates inflammation and bone destruction in rheumatoid arthritis by regulating JAK/STAT3/SOCS3 pathway. Front Immunol. 15:13818022024. View Article : Google Scholar : PubMed/NCBI

Ma J, Kitaura H, Ogawa S, Ohori F, Noguchi T, Marahleh A, Nara Y, Pramusita A, Kinjo R, Kanou K, et al: Docosahexaenoic acid inhibits TNF-α-induced osteoclast formation and orthodontic tooth movement through GPR120. Front Immunol. 13:9296902023. View Article : Google Scholar

Yang J, Shuai J, Siow L, Lu J, Sun M, An W, Yu M, Wang B and Chen Q: MicroRNA-146a-loaded magnesium silicate nanospheres promote bone regeneration in an inflammatory microenvironment. Bone Res. 12:22024. View Article : Google Scholar : PubMed/NCBI

Hua T, Yang M, Song H, Kong E, Deng M, Li Y, Li J, Liu Z, Fu H, Wang Y and Yuan H: Huc-MSCs-derived exosomes attenuate inflammatory pain by regulating microglia pyroptosis and autophagy via the miR-146a-5p/TRAF6 axis. J Nanobiotechnology. 20:3242022. View Article : Google Scholar : PubMed/NCBI

Li XY, Zhang W, Chen J, Yamamoto KJ, Smith JD, Liu F, Garcia MA, Kim SH, Patel RJ, Dubois N, et al: AAV9-delivered miR-146a Reprograms osteoimmune microenvironment via dual suppression of TRAF6/NF-κB axis in postmenopausal osteoporosis. Nat Metab. 37:857–872. 2025.

Chen J, Liu F, Yamamoto K, Smith JD, Wang YC, Zhang W, Garcia MA, Patel R and Tanaka H: miR-21 drives osteoclastogenesis via PDCD4-mediated control of IKKβ Phosphorylation in Postmenopausal Osteoporosis. Cell Rep. 42:103541–103556. 2025.

Zhang J, Rong Y, Luo C and Cui W: Bone marrow mesenchymal stem cell-derived exosomes prevent osteoarthritis by regulating synovial macrophage polarization. Aging (Albany NY). 12:25138–25152. 2020. View Article : Google Scholar : PubMed/NCBI

Han Y, An M, Yang L, Li L, Rao S and Cheng Y: Effect of acid or base interventions on bone health: A systematic review, Meta-analysis, and Meta-regression. Adv Nutr. 12:1540–1557. 2021. View Article : Google Scholar : PubMed/NCBI

He LH, Liu M, He Y, Xiao E, Zhao L, Zhang T, Yang HQ and Zhang Y: TRPV1 deletion impaired fracture healing and inhibited osteoclast and osteoblast differentiation. Sci Rep. 7:423852017. View Article : Google Scholar : PubMed/NCBI

Gong S, Ma J, Tian A, Lang S, Luo Z and Ma X: Effects and mechanisms of microenvironmental acidosis on osteoclast biology. Biosci Trends. 16:58–72. 2022. View Article : Google Scholar

Disthabanchong S, Radinahamed P, Stitchantrakul W, Hongeng S and Rajatanavin R: Chronic metabolic acidosis alters osteoblast differentiation from human mesenchymal stem cells. Kidney Int. 71:201–209. 2007. View Article : Google Scholar

Xu Y, Lu Z, Ling Y, Hou R, Tao J, Deng G, Xu X, Chen X, Ruan J, Zhang Y, et al: Acid sensor ASIC1a induces synovial fibroblast proliferation via Wnt/beta-catenin/c-Myc pathway in rheumatoid arthritis. Int Immunopharmacol. 113:1093282022. View Article : Google Scholar

Chan EL, MacDonald D, Ho SC and Swaminathan R: Potassium intake and urinary calcium excretion in healthy subjects. Miner Electrolyte Metab. 19:36–38. 1993.PubMed/NCBI

Lin L, Luo P, Yang M, Wang J, Hou W and Xu P: Causal relationship between osteoporosis and osteoarthritis: A two-sample Mendelian randomized study. Front Endocrinol (Lausanne). 13:10112462022. View Article : Google Scholar : PubMed/NCBI

Wang Y, Sun L, Dong Z, Zhang T, Wang L, Cao Y, Xu H, Liu C and Chen B: Targeted inhibition of ferroptosis in bone marrow mesenchymal stem cells by engineered exosomes alleviates bone loss in smoking-related osteoporosis. Mater Today Bio. 31:1015012025. View Article : Google Scholar : PubMed/NCBI

Zhang D, Xiao W, Liu C, Wang Z, Liu Y, Yu Y, Jian C and Yu A: Exosomes derived from adipose stem cells enhance bone fracture healing via the activation of the Wnt3a/β-catenin signaling pathway in rats with type 2 diabetes mellitus. Int J Mol Sci. 24:48522023. View Article : Google Scholar

Sun W, Qu S, Ji M, Sun Y and Hu B: BMP-7 modified exosomes derived from synovial mesenchymal stem cells attenuate osteoarthritis by M2 polarization of macrophages. Heliyon. 9:e199342023. View Article : Google Scholar : PubMed/NCBI

Li X, Fang S, Wang S, Xie Y, Xia Y, Wang P, Hao Z, Xu S and Zhang YJ: Hypoxia preconditioning of adipose stem cell-derived exosomes loaded in gelatin methacryloyl (GelMA) promote type H angiogenesis and osteoporotic fracture repair. Nanobiotechnology. 22:1122024. View Article : Google Scholar

Lee AE, Choi JG, Shi SH, He P, Zhang QZ and Le AD: DPSC-derived extracellular vesicles promote rat jawbone regeneration. J Dent Res. 102:313–321. 2023. View Article : Google Scholar

Luo D, Xie W, He X, Zhou X, Ye P and Wang P: Exosomal miR-590-3p derived from bone marrow mesenchymal stem cells promotes osteoblast differentiation and osteogenesis by targeting TGFBR1. In Vitro Cell Dev Biol Anim. 61:46–58. 2025. View Article : Google Scholar

Zhang Y, Cao X, Li P, Fan Y, Zhang L, Ma X, Sun R, Liu Y and Li W: microRNA-935-modified bone marrow mesenchymal stem cells-derived exosomes enhance osteoblast proliferation and differentiation in osteoporotic rats. Life Sci. 272:1192042021. View Article : Google Scholar : PubMed/NCBI

Marini F, Giusti F, Palmini G and Brandi ML: Role of Wnt signaling and sclerostin in bone and as therapeutic targets in skeletal disorders. Osteoporos Int. 34:213–238. 2023. View Article : Google Scholar

Komori T: Bone development by Hedgehog and Wnt signaling, Runx2, and Sp7. J Bone Miner Metab. 43:33–38. 2025. View Article : Google Scholar

Samman WA, Mosalam EM, Saif DS, Abdallah MS, Zidan AA, Sallam AS, Abdelsattar S, Khalil FO, Elashkar AE, Mohamed SM, et al: Deciphering the role of Wnt/β-catenin and miR-214 in knee osteoarthritis: Molecular and clinical insights. Front Pharmacol. 16:15076932025. View Article : Google Scholar

Danz JC and Degen M: Selective modulation of the bone remodeling regulatory system through orthodontic tooth movement-a review. Front Oral Health. 6:14727112025. View Article : Google Scholar : PubMed/NCBI

Coombs CV, Greeves JP, Young CD, Irving AS, Eisenhauer A, Kolevica A, Heuser A, Tang JCY, Fraser WD and O'Leary TJ: The effect of calcium supplementation on bone calcium balance and calcium and bone metabolism during load carriage in women: A randomized controlled crossover trial. J Bone Miner Res. 13:zjaf0042025.

Rummler M, Ziouti F, Snyder L, Zimmermann EA, Lynch M, Donnelly E, Wagermaier W, Jundt F and Willie BM: Bone mechanical properties were altered in a mouse model of multiple myeloma bone disease. Biomater Adv. 166:2140472025. View Article : Google Scholar

Cai G, Lu Y, Zhong W, Wang T, Li Y, Ruan X, Chen H, Sun L, Guan Z, Li G, et al: Piezo1-mediated M2 macrophage mechanotransduction enhances bone formation through secretion and activation of transforming growth factor-β1. Cell Prolif. 56:e134402023. View Article : Google Scholar

Zhang J, Tong Y, Liu Y, Lin M, Xiao Y and Liu C: Mechanical loading attenuated negative effects of nucleotide analogue reverse-transcriptase inhibitor TDF on bone repair via Wnt/β-catenin pathway. Bone. 161:1164492022. View Article : Google Scholar

Hiasa M, Endo I and Matsumoto T: Bone-fat linkage via interleukin-11 in response to mechanical loading. J Bone Miner Metab. 42:447–454. 2024. View Article : Google Scholar : PubMed/NCBI

Bullock WA, Pavalko FM and Robling AG: Osteocytes and mechanical loading: The Wnt connection. Orthod Craniofac Res. 22(Suppl 1): S175–S179. 2019. View Article : Google Scholar

Simic MK, Mohanty ST, Xiao Y, Cheng TL, Taylor VE, Charlat O, Croucher PI and McDonald MM: Multi-Targeting DKK1 and LRP6 prevents bone loss and improves fracture resistance in multiple myeloma. J Bone Miner Res. 38:814–828. 2023. View Article : Google Scholar : PubMed/NCBI

Xun J, Li C, Liu M, Mei Y, Zhou Q, Wu B, Xie F, Liu Y and Dai R: Serum exosomes from young rats improve the reduced osteogenic differentiation of BMSCs in aged rats with osteoporosis after fatigue loading in vivo. Stem Cell Res Ther. 12:4242021. View Article : Google Scholar : PubMed/NCBI

Qi J, Zhang R and Wang Y: Exosomal miR-21-5p derived from bone marrow mesenchymal stem cells promote osteosarcoma cell proliferation and invasion by targeting PIK3R1. J Cell Mol Med. 25:11016–11030. 2021. View Article : Google Scholar : PubMed/NCBI

Liu W, Li L, Rong Y, Qian D, Chen J, Zhou Z, Luo Y, Jiang D, Cheng L, Zhao S, et al: Hypoxic mesenchymal stem cell-derived exosomes promote bone fracture healing by the transfer of miR-126. Acta Biomater. 103:196–212. 2020. View Article : Google Scholar

Neogi T and Colloca L: Placebo effects in osteoarthritis: Implications for treatment and drug development. Nat Rev Rheumatol. 19:613–626. 2023. View Article : Google Scholar : PubMed/NCBI

Olansen J, Dyke JP and Aaron RK: Is osteoarthritis a vascular disease? Front Biosci (Landmark Ed). 29:1132024. View Article : Google Scholar : PubMed/NCBI

Zaussinger M, Schwaiger K, Schwarzbauer J, Bachleitner K, Holzbauer M, Ehebruster G and Schmidt M: Three-dimensional planning for vascularized bone grafts: Implementation and surgical application for complex bone reconstruction in the hand and forearm. J Clin Med. 14:4402025. View Article : Google Scholar : PubMed/NCBI

Song LL, Tang YP, Qu YQ, Yun YX, Zhang RL, Wang CR, Wong VKW, Wang HM, Liu MH, Qu LQ, et al: Exosomal delivery of rapamycin modulates Blood-brain barrier penetration and VEGF axis in glioblastoma. J Control Release. 381:1136052025. View Article : Google Scholar : PubMed/NCBI

Anderson JD, Johansson HJ, Graham CS, Vesterlund M, Pham MT, Bramlett CS, Montgomery EN, Mellema MS, Bardini RL, Contreras Z, et al: Comprehensive proteomic analysis of mesenchymal stem cell exosomes reveals modulation of angiogenesis via nuclear Factor-KappaB signaling. Stem Cells. 34:601–613. 2016. View Article : Google Scholar : PubMed/NCBI

Vyas KS, Kaufman J, Munavalli GS, Robertson K, Behfar A and Wyles SP: Exosomes: The latest in regenerative aesthetics. Regen Med. 18:181–194. 2023. View Article : Google Scholar : PubMed/NCBI

Shen K, Duan A, Cheng J, Yuan T, Zhou J, Song H, Chen Z, Wan B, Liu J, Zhang X, et al: Exosomes derived from hypoxia preconditioned mesenchymal stem cells laden in a silk hydrogel promote cartilage regeneration via the miR-205-5p/PTEN/AKT pathway. Acta Biomater. 143:173–188. 2022. View Article : Google Scholar : PubMed/NCBI

Wang Y, Kong Y, Du J, Qi L, Liu M, Xie S, Hao J, Li M, Cao S, Cui H, et al: Injection of human umbilical cord mesenchymal stem cells exosomes for the treatment of knee osteoarthritis: From preclinical to clinical research. J Transl Med. 23:6412025. View Article : Google Scholar : PubMed/NCBI

Rajabloo Y, Al-Asady AM, Avan A, Khazaei M, Ryzhikov M and Hassanian SM: Unlocking therapeutic potential: Mesenchymal stem Cells-derived exosomes in IUA treatment, current status and perspectives. Curr Pharm Des. 31:1663–1672. 2025. View Article : Google Scholar : PubMed/NCBI

Infante A and Rodríguez CI: Osteogenesis and aging: Lessons from mesenchymal stem cells. Stem Cell Res Ther. 9:2442018. View Article : Google Scholar : PubMed/NCBI

Liu S, Liu D, Chen C, Hamamura K, Moshaverinia A, Yang R, Liu Y, Jin Y and Shi S: MSC transplantation improves osteopenia via epigenetic regulation of Notch signaling in lupus. Cell Metab. 22:606–618. 2015. View Article : Google Scholar : PubMed/NCBI

Zhang L, Jiao G, Ren S, Zhang X, Li C, Wu W, Wang H, Liu H, Zhou H and Chen Y: Exosomes from bone marrow mes enchymal stem cells enhance fracture healing through the promotion of osteogenesis and angiogenesis in a rat model of nonunion. Stem Cell Res Ther. 11:382020. View Article : Google Scholar

Chen S, Tang Y, Liu Y, Zhang P, Lv L, Zhang X, Jia L and Zhou Y: Exosomes derived from miR-375-overexpressing human adipose mesenchymal stem cells promote bone regeneration. Cell Prolif. 52:e126692019. View Article : Google Scholar : PubMed/NCBI

Zhou QF, Cai YZ and Lin XJ: The dual character of exosomes in osteoarthritis: Antagonists and therapeutic agents. Acta Biomater. 105:15–25. 2020. View Article : Google Scholar : PubMed/NCBI

Chen P, Zheng L, Wang Y, Tao M, Xie Z, Xia C, Gu C, Chen J, Qiu P, Mei S, et al: Desktop-stereolithography 3D printing of a radially oriented extracellular matrix/mesenchymal stem cell exosome bioink for osteochondral defect regeneration. Theranostics. 9:2439–2459. 2019. View Article : Google Scholar : PubMed/NCBI

Liu X, Yang Y, Li Y, Niu X, Zhao B, Wang Y, Bao C, Xie Z, Lin Q and Zhu L: Integration of stem cell-derived exosomes with in situ hydrogel glue as a promising tissue patch for articular cartilage regeneration. Nanoscale. 9:4430–4438. 2017. View Article : Google Scholar : PubMed/NCBI

Li W, Liu Y, Zhang P, Tang Y, Zhou M, Jiang W, Zhang X, Wu G and Zhou Y: Tissue-engineered bone immobilized with human adipose stem cells-derived exosomes promotes bone regeneration. ACS Appl Mater Interfaces. 10:5240–5254. 2018. View Article : Google Scholar : PubMed/NCBI

Ni Z, Zhou S, Li S, Kuang L, Chen H, Luo X, Ouyang J, He M, Du X and Chen L: Exosomes: Roles and therapeutic potential in osteoarthritis. Bone Res. 8:252020. View Article : Google Scholar : PubMed/NCBI

Rudiansyah M, El-Sehrawy AA, Ahmad I, Terefe EM, Abdelbasset WK, Bokov DO, Salazar A, Rizaev JA, Muthanna FMS and Shalaby MN: Osteoporosis treatment by mesenchymal stromal/stem cells and their exosomes: Emphasis on signaling pathways and mechanisms. Life Sci. 306:1207172022. View Article : Google Scholar : PubMed/NCBI

Zhang L, Wang Q, Su H and Cheng J: Exosomes from adipose derived mesenchymal stem cells alleviate diabetic osteoporosis in rats through suppressing NLRP3 inflammasome activation in osteoclasts. J Biosci Bioeng. 131:671–678. 2021. View Article : Google Scholar : PubMed/NCBI

Liang Y, Xu X, Li X, Xiong J, Li B, Duan L, Wang D and Xia J: Chondrocyte-targeted microRNA delivery by engineered exosomes toward a cell-free osteoarthritis therapy. ACS Appl Mater Interfaces. 12:36938–36947. 2020. View Article : Google Scholar : PubMed/NCBI

He L, He T, Xing J, Zhou Q, Fan L, Liu C, Chen Y, Wu D, Tian Z, Liu B and Rong L: Bone marrow mesenchymal stem cell-derived exosomes protect cartilage damage and relieveknee osteoarthritis pain in a rat model of osteoarthritis. Stem Cell Res Ther. 11:2762020. View Article : Google Scholar

Lu M, Lou A, Gao J, Li S, He L, Fan W and Zhao L: Quercetin-primed MSC exosomes synergistically attenuate osteoarthritis progression. J Orthop Surg Res. 20:3732025. View Article : Google Scholar : PubMed/NCBI

Chen Q, Lin Y, Li W, Zhang X, Asahara H, Zheng M, Zhang YC, Xie T, Sun LY, Chang J, et al: Engineered cartilage-targeting extracellular vesicles deliver anti-inflammatory RNAi therapy for osteoarthritis treatment. Sci Transl Med. 17:eabn02592025.

Zhang Y, Kirkland JL, Chen W, Qin L, Chen X, Yang H, Zhang T, Lin JH, Zhang ZM, Cao X, et al: Systemically administered exosomes derived from mesenchymal stem cells mitigate bone loss by targeting osteogenesis in postmenopausal osteoporosis. Nat Commun. 15:32182024.

Yoo J, Lee SK, Lim M, Sheen D, Choi EH and Kim SA: Exosomal amyloid A and lymphatic vessel endothelial hyaluronic acid receptor-1 proteins are associated with disease activity in rheumatoid arthritis. Arthritis Res Ther. 19:1192017. View Article : Google Scholar : PubMed/NCBI

Zhao Y and Xu J: Synovial fluid-derived exosomal lncRNA PCGEM1 as biomarker for the different stages of osteoarthritis. Int Orthop. 42:2865–2872. 2018. View Article : Google Scholar : PubMed/NCBI

Zhang Y, Cai F, Liu J, Chang H, Liu L, Yang A and Liu X: Transfer RNA-derived fragments as potential exosome tRNA-derived fragment biomarkers for osteoporosis. Int J Rheum Dis. 21:1659–1669. 2018. View Article : Google Scholar : PubMed/NCBI

Wang L, Wang C, Jia X and Yu J: Circulating exosomal miR-17 inhibits the induction of regulatory T cells via suppressing TGFBR II expression in rheumatoid arthritis. Cell Physiol Biochem. 50:1754–1763. 2018. View Article : Google Scholar : PubMed/NCBI

Xia B, Di Chen, Zhang J, Hu S, Jin H and Tong P: Osteoarthritis pathogenesis: A review of molecular mechanisms. Calcif Tissue Int. 95:495–505. 2014. View Article : Google Scholar : PubMed/NCBI

Zhang E, Chen L, Wang YF, Smith JR, Yamamoto HE and Johnson SK: Cryopreservation of exosomes with enhanced bioactivity using liquid nitrogen and novel cryoprotectants. Nat Commun. 15:1238–1256. 2024.

Stevenson J; Medical advisory council of the British Menopause Society: Prevention and treatment of osteoporosis in women. Post Reprod Health. 29:11–14. 2023. View Article : Google Scholar :

Galanis A, Dimopoulou S, Karampinas P, Vavourakis M, Papagrigorakis E, Sakellariou E, Karampitianis S, Zachariou D, Theodora M, Antsaklis P, et al: The correlation between transient osteoporosis of the hip and pregnancy: A review. Medicine (Baltimore). 102:e354752023. View Article : Google Scholar : PubMed/NCBI

Gehrke B, Alves Coelho MC, Brasil d'Alva C and Madeira M: Long-term consequences of osteoporosis therapy with bisphosphonates. Arch Endocrinol Metab. 68:e2203342023. View Article : Google Scholar : PubMed/NCBI

Yu S, Chen H and Gao B: Potential therapeutic effects of exosomes in regenerative endodontics. Arch Oral Biol. 120:1049462020. View Article : Google Scholar : PubMed/NCBI

Munagala R, Aqil F, Jeyabalan J and Gupta RC: Bovine Milk-derived exosomes for drug delivery. Cancer Lett. 371:48–61. 2016. View Article : Google Scholar :

Zhang S, Wong KL, Ren X, Teo KYW, Afizah H, Choo ABH, Lai RC, Lim SK, Hui JHP and Toh WS: Mesenchymal stem cell exosomes promote functional osteochondral repair in a clinically relevant porcine model. Am J Sports Med. 50:788–800. 2022. View Article : Google Scholar : PubMed/NCBI