Mesenchymal Stem Cell Therapy in Osteoarthritis and Rheumatoid Arthritis - A Systematic Review of Exosomal microRNAs

Sep 30, 2026

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A systematic review evaluates mesenchymal stem cell (MSC)-derived exosomal microRNAs as a cell-free therapeutic strategy for osteoarthritis (OA) and rheumatoid arthritis (RA). Searches in Web of Science, PubMed, Scopus, and Google Scholar up to 24 March 2024 identified 55 eligible articles (41 OA, 14 RA). Exosomal miRNAs showed anti-inflammatory, protective, and chondroregenerative effects in vitro and in vivo by modulating multiple signaling pathways, with candidate miRNAs highlighted for each disease. Preclinical evidence supports clinical translation, while human studies and additional trials are needed.

LanguageEnglish

CategoryHealthcare

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Pages39

Reading Time1 h 38 min

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Summary

Introduction

Methods

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Biologics: Targets and Therapy Open Access Full Text Article REVIEW Mesenchymal Stem Cell Therapy in Osteoarthritis and Rheumatoid Arthritis: A Systematic Review of Exosomal microRNAs Seyyed Sina Hejazian 1 , 2 , Seyyedeh Mina Hejazian 3 , Seyede Saba Mostafavi Montazeri4 , Sima Abediazar 3 , Sepideh Zununi Vahed 3 , Abolfazl Barzegari 5–7 1Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 4Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran; 5Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; 6Research Center for Pharmaceutical Nanotechnology (RCPN), Tabriz University of Medical Sciences, Tabriz, Iran; 7Laboratory for Vascular Translational Science, Nanotechnologies for Vascular Medicine and Imaging Team, Université Sorbonne Paris Nord, Villetaneuse, 93430, France Correspondence: Sepideh Zununi Vahed, Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, Email [sepide.zununi@gmail.com](sepide.zununi@gmail.com); Abolfazl Barzegari, Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran, Email [abolfazl.barzegari@gmail.com](abolfazl.barzegari@gmail.com) | Summary: Osteoarthritis (OA) and rheumatoid arthritis (RA) are chronic diseases characterized by persistent inflammation and autoimmune responses that affect the joints and other organs. Scientific evidence indicates that the therapeutic effects of mesenchymal stem cells (MSCs) are mediated through the release of soluble factors and extracellular vesicles (EVs), particularly exosomes. The release of microRNAs from MSCs holds substantial potential for cell-free treatment in OA and RA.
Methods: A comprehensive search was conducted on Web of Science, PubMed, Scopus, and Google Scholar to identify relevant publications until 24 March 2024. The systematic review aimed at illuminating the current understanding of MSC-derived exosomal microRNAs, the origin of MSCs, potential mechanisms of action, and their therapeutic implications in managing OA and RA. Results: A total of fifty-five articles (OA, n= 41 and RA, n= 14) were deemed eligible for inclusion in this study. Regardless of MSC origin, exosomal miRNAs could induce anti-inflammatory, protective, and chondroregenerative potential in in vitro and in vivo models of OA by targeting different signaling pathways. Fourteen studies have highlighted the role of MSC-derived exosomal miRNAs in modulating immune responses, reducing pro-inflammatory cytokine production, and potentially ameliorating synovial inflammation and joint symptoms associated with RA. To suppress joint inflammation and preserve cartilage, miR-140, miR-92a-3p, and miR-136- 5p emerged as leading candidates for OA because they help restore the anabolic/catabolic balance and modulate key signaling pathways. For RA, the most effective candidates were miR-146a, miR-150-5p and miR-205-5p that target innate and adaptive immune signaling and synoviocyte activation, with NF-κB modulators such as miR-361-5p offering overlap across both diseases. Conclusion: The mounting body of preclinical evidence supports that MSC-exosomal-miRNAs present a promising solution for OA and RA as a novel therapeutic strategy. However, human studies and more clinical trials are warranted.
Keywords: arthritis, extracellular vesicles, miRNAs, stem cells, MSCs, osteoarticular disease | | --- | | Introduction
Osteoarthritis (OA) and rheumatoid arthritis (RA), the most common types of arthritis, are chronic inflammatory, autoimmune, and age-related osteoarticular diseases. They are characterized by the degeneration of cartilage and the inflammation of the synovial membrane, respectively. Both O

FAQs

What is the main therapeutic focus of the review?

The review focuses on MSC-derived exosomal microRNAs as a potential cell-free treatment approach for osteoarthritis and rheumatoid arthritis.

How many studies were included, and how were they distributed?

Fifty-five articles were included: 41 related to osteoarthritis and 14 related to rheumatoid arthritis.

Which microRNAs are highlighted as leading candidates for OA and RA?

For OA, miR-140, miR-92a-3p, and miR-136-5p are emphasized. For RA, miR-146a, miR-150-5p, and miR-205-5p are identified, with miR-361-5p noted as overlapping across both diseases.

Sep 30, 2026

Uploaded by Mabel