Exploring Extracellular Vesicles As Novel Therapeutic Agents For Intervertebral Disc Degeneration: Delivery, Applications, And Mechanisms

This review examines the potential of extracellular vesicles (EVs) as therapeutic agents for intervertebral disc degeneration (IVDD), a condition primarily affecting the elderly. Current treatments mainly provide symptomatic relief without addressing the underlying degeneration. EVs, which are lipid bilayer structures, can deliver proteins, RNA, and lipids to modulate inflammatory and degenerative pathways, offering anti-inflammatory, anti-apoptotic, and extracellular matrix restorative effects. The review discusses the challenges in effectively utilizing EVs, such as isolation and purification difficulties, and emphasizes the need for further research to optimize EV therapy, including bioengineering and drug loading enhancements. Despite these challenges, EVs, particularly those derived from mesenchymal stem cells, show promise as a novel strategy for IVDD treatment by targeting multiple pathological mechanisms.