[Research progress of exosome carrying RNA in the treatment of hormone-induced osteonecrosis].

Abstract

Osteonecrosis is a metabolic disease commonly induced by glucocorticoid administration, which impedes the blood supply to bone, promotes osteocyte death, and subsequently leads to alterations in bone structure and collapse of the femoral head. Key molecular mechanisms include osteocyte apoptosis, dysregulated autophagy, oxidative stress, and vascular endothelial dysfunction, among others. Although progress has been made in understanding the pathogenesis of steroid-induced osteonecrosis, the development of effective preventive and therapeutic strategies remains an ongoing challenge. Exosomes are extracellular vesicles secreted by cells and serve as crucial mediators of intercellular communication. Their unique cargo capacity enables them to transport bioactive molecules, including ribonucleic acid (RNA), between cells. Increasing evidence suggests that RNA-loaded exosomes exert dual therapeutic effects:directly promoting osteogenesis and angiogenesis, and modulating pathological processes via the delivery of regulatory RNAs. These properties indicate that exosomes hold immense potential for targeted intervention and therapy in osteonecrosis.