The function,mechanism and clinical treatment of exosomes in intervertebral disc degeneration
Intervertebral disc degeneration(IVDD)is the main cause of low back pain,and the prevalence rate is increasing year by year.However,the exact cause of IVDD is still unclear.Most conservative treatment and surgical treatment can not prevent the progress of IVDD or restore the original structure and function,and are often accompanied by obvious sequelae and complications.Exosomes are extracellular vesicles with a diameter of 40-160 nm,which are composed of lipid bilayers encapsulating proteins,nucleic acids,etc.,and play an important regulatory role as intercellular communication substances.By delivering a large number of bioactive substances to damaged cells,exosomes have received great attention in maintaining the stability of intervertebral disc structure and function.However,there are still some challenges in the production,application and efficacy evaluation of exosomes,which are worthy of further exploration.This article focuses on the mechanism of exosomes from different sources in regulating cell proliferation and apoptosis,endoplasmic reticulum stress,inflammation,pyroptosis,oxidative stress,autophagy,extracellular matrix stability,differentiation and angiogenesis in the process of IVDD in recent years,in order to provide thinking for subsequent in-depth research.