Mesenchymal stem/stromal cells and their exosomes as natural nano-particles for arthritis therapy; hype and hope

In order to reduce cartilage damage and enhance tissue regeneration in a variety of musculoskeletal conditions, particularly rheumatoid arthritis (RA) and osteoarthritis (OA), mesenchymal stem/stromal cells (MSCs)-based treatments have attracted increasing attention. The effects of MSCs are primarily controlled by inhibiting inflammatory reactions and inducing immunomodulation, which is largely accomplished by the secretion of a variety of anti-inflammatory cytokines. These mediators prevent the proliferation and motility of FLS in vivo, which prevents cartilage degeneration. Furthermore, MSCs-derived nanometric exosome therapy can inhibit the activity of matrix metalloproteinases (MMPs), which function as matrix-degrading enzymes, and ultimately results in decreased extracellular matrix (ECM) breakdown. MSCs-derived exosome in fact act as cell-free sources in the context of the regenerative medicine. In addition, administration of MSCs intravenously and systemically to patients with OA and RA has been shown to be safe and effective therapeutically. Here, we have focused on the ability of MSC-based approaches like using MSCs-derived exosome to favor both chondrogenic and chondroprotective influences in arthritis.