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2022, Vol. 26 ›› Issue (19): 3056-3064

Regulatory mechanism of exosomes in signal communication network of steroid induced avascular necrosis of the femoral head repair

Wang Weiwei1, Ou Zhixue2, Zhang Xiaoyun1, Li Shibin1, Zhou Yi1, Li Tong1   

  1. 1Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530000, Guangxi Zhuang Autonomous Region, China; 2Guilin Hospital of Traditional Chinese Medicine, Guilin 541002, Guangxi Zhuang Autonomous Region, China

  • Received:2021-07-05 Revised:2021-07-26 Accepted:2021-08-16 Online:2022-07-08 Published:2021-12-29

  • Contact: Ou Zhixue, MD, Chief physician, Guilin Hospital of Traditional Chinese Medicine, Guilin 541002, Guangxi Zhuang Autonomous Region, China Zhang Xiaoyun, Associate chief physician, Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530000, Guangxi Zhuang Autonomous Region, China

  • About author:Wang Weiwei, Master candidate, Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530000, Guangxi Zhuang Autonomous Region, China

  • Supported by:

    National Natural Science Foundation of China, No. 81960803 (to ZXY); Youth Fund of Guangxi Natural Science Foundation, No. 2020GXNSFBA159053 (to ZXY); Guangxi University Young Teachers Basic Ability Improvement Project, No. 2019KY0352 (to ZXY); Guangxi University of Traditional Chinese Medicine 2019 School-Level Scientific Research Project, No. 2019QN027 (to ZXY); Guangxi University of Traditional Chinese Medicine First-Class Subject Project, No. 2019XK026, 2019XK029 (to ZXY)



Abstract: BACKGROUND: The prevalence of steroid induced avascular necrosis of the femoral head is increasing year by year, and exosomes, as a major focus of current research, have highlighted the advantages and value of their applications in osteogenesis, angiogenesis, and bone tissue engineering.
OBJECTIVE: To summarize the current research progress of exosomes in steroid induced avascular necrosis of the femoral head.
METHODS: CNKI, Wanfang, VIP, Chinese Biomedical Literature Database, PubMed, Embase, Medline, and Web of Science were retrieved for relevant articles. Search terms were “exosomes, steroid induced avascular necrosis of the femoral head, mesenchymal stem cells, blood vessel, fat metabolism, tissue engineering, osteoblast, osteoclasts, synovial cells, chondrocytes, bone cells, platelet-rich plasma” in Chinese and English. The time was set from 2000 to 2021. Totally, 63 articles were screened according to the inclusion and exclusion criteria.

RESULTS AND CONCLUSION: (1) Exosomes are used as transport vehicles to closely link the signal communication network formed between mesenchymal stem cells, endothelial cells, osteoblasts, osteoclasts, synovial cells, chondrocytes and osteocytes, and regulate osteogenesis and angiogenesis, which plays an important role in the repair of hormonal osteonecrosis of the femoral head. (2) It mainly regulates the proliferation, apoptosis, and differentiation of other cells in the signal communication network through Wnt/β-catenin and PI3K/AKT signal pathways, thereby improving the imbalance of the communication network caused by hormones. (3) This article preliminarily explained the role of exosomes in steroid induced avascular necrosis of the femoral head. However, because the current correlation studies mostly focus on the metabolic abnormalities of a single cell, the specific situation of the coupling mechanism has not been systematically clarified. (4) In addition, due to current technical limitations, the absolute safety of exosomes to organisms has not been scientifically verified. The extraction, identification, and storage of exosomes have high requirements on technology and equipment, and they can carry and continuously release exosomes. The research and development mechanism of biophilic materials is not yet mature, which limits the clinical promotion of exosomal therapy to a certain extent. (5) Based on the existing related mechanisms and bio-credit results, the research on the coupling mechanism of exosomes in steroid induced avascular necrosis of the femoral head bone tissue repair should be carried out; extraction, identification, and preservation techniques of exosomes should be improved to reduce certain experimental errors, so as to avoid some contradictory experimental conclusions and further analyze the relevant components in different sources of exosomes, which can provide a certain prerequisite and basis for clinical applications. (6) Based on the existing relevant experimental basis, in the future, it is necessary to continue to study the mechanism of the related target cells in the exchange network of exosomes combined with repair and the corresponding bone tissue biomaterials.

Key words:exosomes, steroid-induced avascular necrosis of the femoral head, angiogenesis, bone tissue engineering, osteoblasts, osteoclasts, mesenchymal stem cells, endothelial cells


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