关节软骨是人体重要的承重组织, 其生物力学功能的维持依赖于结构的完整性。然而, 由于缺乏血液供应, 致使其损伤后难以自我修复, 易导致骨关节炎和软骨退化性疾病。近年来, 脂肪间充质干细胞(adipose-derived mesenchymal stem cells, ADSCs)凭借其来源丰富、分离便捷等优势, 已被广泛应用于再生医学的研究中。由ADSCs旁分泌产生的外泌体不仅继承了亲本细胞的生物学特性,还具有低免疫原性、良好的生物屏障渗透性以及高稳定性, 是细胞间信号传导的重要介质。ADSCs外泌体携带的RNA、蛋白质及生物因子能够调节免疫反应、促进软骨细胞增殖并增强其代谢活性。此外, 外泌体还可通过上调成软骨基因的表达, 抑制软骨降解基因, 进而改善细胞外基质, 促进软骨修复。作为一种优质的纳米药物载体, 外泌体与生物工程相结合, 可显著提高受损软骨的修复效率。本文对ADSCs来源的外泌体在软骨修复及相关疾病中的应用及其作用机制进行了综述, 以期为外泌体疗法的标准化以及软骨损伤的临床治疗提供参考。

Articular cartilage is crucial weight-bearing tissue in the human body,and the maintenance of its biomechanical functions relies on the integrity of the structure. However, due to the lack of blood supply,it is inherently limited in its ability to self-repair after injury, which can readily lead to osteoarthritis and cartilage degenerative diseases.In recent years,adipose derived mesenchymal stem cells (ADSCs) have been widely used in regenerative medicine research due to their abundant sources and convenient isolation.Exosomes derived from these cells through paracrine signaling not only inherit the biological characteristics of the parent cells, but also exhibit low immunogenicity, favorable biobarrier permeability, and high stability, making them essential mediators of intercellular signal transduction. Research has demonstrated that the RNA, proteins, and bioactive factors carried by exosomes derived from ADSCs can regulate immune responses, promote chondrocytes cell proliferation, and enhance the metabolism and activity. Meanwhile, they can also upregulate chondrogenic gene expression and inhibit cartilage-degrading genes, thereby improving the extracellular matrix and promoting cartilage repair. As high-quality nanocarriers for drugs, the combination of exosomes with bioengineering can effectively improve the repair efficiency of damaged cartilage. This review summarizes the applications and mechanisms of ADSCs-derived exosomes in cartilage repair and associated diseases, aiming to provide insights for the standardization of exosome-based therapies and the clinical treatment of cartilage injuries.