Extracellular vesicles as therapeutic agents in rheumatoid arthritis: a systematic review of current evidence.

IF 4.6 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2025-03-01 DOI:10.1007/s10787-025-01670-9

Xiaolei Miao, Amirreza Ghafourian, Mahdi Karimi Khaneghah, Seyed Mohammad Ayyoubzadeh, Reza Afrisham, Mahnaz Ahmadi

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引用次数: 0

Abstract

Rheumatoid arthritis (RA) is defined as a chronic autoimmune disease that severely influences a patient's quality of life. Extracellular vesicles (EVs) have gained much attention in recent years as one of the most potent therapeutic agents for the treatment of RA. A systematic review was performed with the purpose of assessing the current evidence relating to the therapeutic applications of EVs in RA. The systematic search was performed in the databases of PubMed, Scopus, and Web of Science, from inception times to September 2024. All studies investigating the use of EVs for the treatment of RA were included. The quality appraisal of selected articles and data extraction regarding EV characteristics, therapeutic applications, and associated outcomes were performed. Of the 1418 initially identified articles, 59 studies met inclusion criteria. Regarding their cellular origins, most EVs were derived from mesenchymal stem cells, followed by immune cells. The main therapeutic mechanisms included modulation of the immune response, reduction of inflammation, and repair of tissues. Recent trends are toward increasing interest in engineered EVs and combination therapies. Indeed, most studies reported positive outcomes with regard to lowered inflammation and improved joint function. On the other hand, standardization of the metrics of evaluation considerably varied between different studies. EVs are promising therapeutic agents in the treatment of RA by modulating immune responses. Standardization, delivery systems, and clinical translation are challenges yet to be overcome. Future studies will be directed to optimize EV engineering, targeted delivery systems, and large-scale clinical trials.

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]