细胞外囊泡在治疗膝骨关节炎中的作用与前景

膝骨关节炎（knee osteoarthritis,KOA）是以关节软骨退变为主要病变的退行性疾病。目前，KOA尚无有效治疗药物。细胞外囊泡（extracellular vesicles,EVs）是由细胞释放的脂质双分子层包绕形成的球状膜性囊泡，可在细胞间传递核酸、蛋白质等生物活性分子。与动物来源EVs相比，植物来源EVs因其来源广泛且经济，在药物载体递送研究领域引起广泛关注。通过基因工程等方法改造EVs进行药物递送，可极大提高药物递送效率及其疗效。本文综述了动、植物两种来源的EVs在KOA中的治疗进展，特别聚焦于工程化EVs作为药物递送载体在KOA治疗中的研发现状，旨在为利用EVs治疗KOA提供参考。

The Therapeutic Potential of Extracellular Vesicles in Knee Osteoarthritis

Knee osteoarthritis (KOA) is a degenerative disease characterized by degeneration of articular cartilage. So far, there is no effective drug to treat KOA. Extracellular vesicles (EVs) are spherical membranous vesicles formed by the envelopment of lipid bilayers released from cells, which can deliver bioactive molecules such as nucleic acids and proteins between cells. Mesenchymal stem cell derived EVs can be used as an effective way in KOA treatment by reducing inflammation and promoting cartilage repair. Compared with mammalian-derived EVs, plant-derived EVs have attracted much attention in the field of drug carrier delivery research because of their wide and economical sources. It is worth noting that vesicles derived from Chinese herbal medicine have great prospects in disease treatment. Modification of EVs for drug delivery by genetic engineering and other methods can greatly improve drug delivery efficiency and its efficacy. In addition, the hybrid vesicles prepared by membrane fusion can efficiently deliver CRISPR/Cas9 plasmids for KOA treatment. Because of its diversified functions and modifiability, EVs have great prospects in disease treatment and drug delivery. This paper reviews the progress of EVs from animals and plants in the treatment of KOA, focusing on the research and development of engineered EVs as drug delivery carriers in KOA treatment, in order to provide a reference for the use of EVs in the treatment of KOA.