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Allogenic mesenchymal stem cell-derived exosomes (MSC-Exos) are an investigational biologic therapy being developed by Isfahan University of Medical Sciences for the treatment of knee osteoarthritis. These exosomes are small (30-150 nm) extracellular vesicles secreted by mesenchymal stem cells that carry a cargo of bioactive molecules, including proteins, lipids, and non-coding RNAs (ncRNAs). When administered via intra-articular injection, they exert therapeutic effects by modulating the immune environment, reducing the expression of pro-inflammatory cytokines, and inhibiting matrix-degrading enzymes such as matrix metalloproteinases (MMPs) and ADAMTS. This paracrine signaling mechanism aims to suppress chondrocyte apoptosis and promote the regeneration of the extracellular matrix and cartilage in the osteoarthritic joint.
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