Abstract：
OBJECTIVE: This systematic review aims to evaluate existing evidence to investigate the therapeutic efficacy of M2 macrophage-derived exosomes in bone regeneration.
METHODS: A comprehensive search between 2020 and 2024 across PubMed, Web of Science, and Scopus was conducted using a defined search strategy to identify relevant studies regarding the following question: \"What is the impact of M2 macrophage-derived exosomes on bone regeneration?\". Controlled in vitro and in vivo studies were included in this study. The SYRCLE tool was used to evaluate the risk of bias in the included animal studies.
RESULTS: This review included 20 studies published. Seven studies were selected for only in vitro analysis, whereas 13 studies underwent both in vitro and in vivo analyses. The in vivo studies employed animal models, including 163 C57BL6 mice and 73 Sprague-Dawley rats. Exosomes derived from M2 macrophages were discovered to be efficacious in promoting bone regeneration and vascularization in animal models of bone defects. These effects were primarily confirmed through morphological and histological assessments. This remarkable outcome is attributed to the regulation of multiple signaling pathways, as evidenced by the findings of 11 studies investigating the involvement of miRNAs in this intricate process. In addition, in vitro studies observed positive effects on cell proliferation, migration, osteogenesis, and angiogenesis. Heterogeneity in study methods hinders direct comparison of results across studies.
CONCLUSIONS: M2 macrophage-derived exosomes demonstrate remarkable potential for promoting bone regeneration. Further research optimizing their application and elucidating the underlying mechanisms can pave the way for clinical translation.
METHODS: A comprehensive search between 2020 and 2024 across PubMed, Web of Science, and Scopus was conducted using a defined search strategy to identify relevant studies regarding the following question: \"What is the impact of M2 macrophage-derived exosomes on bone regeneration?\". Controlled in vitro and in vivo studies were included in this study. The SYRCLE tool was used to evaluate the risk of bias in the included animal studies.
RESULTS: This review included 20 studies published. Seven studies were selected for only in vitro analysis, whereas 13 studies underwent both in vitro and in vivo analyses. The in vivo studies employed animal models, including 163 C57BL6 mice and 73 Sprague-Dawley rats. Exosomes derived from M2 macrophages were discovered to be efficacious in promoting bone regeneration and vascularization in animal models of bone defects. These effects were primarily confirmed through morphological and histological assessments. This remarkable outcome is attributed to the regulation of multiple signaling pathways, as evidenced by the findings of 11 studies investigating the involvement of miRNAs in this intricate process. In addition, in vitro studies observed positive effects on cell proliferation, migration, osteogenesis, and angiogenesis. Heterogeneity in study methods hinders direct comparison of results across studies.
CONCLUSIONS: M2 macrophage-derived exosomes demonstrate remarkable potential for promoting bone regeneration. Further research optimizing their application and elucidating the underlying mechanisms can pave the way for clinical translation.
摘要：
目的：本系统综述旨在评估现有证据，以研究M2巨噬细胞衍生的外泌体在骨再生中的治疗效果。
方法：在PubMed的2020年至2024年之间进行的全面搜索，WebofScience,使用确定的搜索策略进行Scopus，以确定有关以下问题的相关研究：“M2巨噬细胞衍生的外泌体对骨再生有什么影响？”本研究包括体外和体内对照研究。SYRCLE工具用于评估纳入动物研究中的偏倚风险。
结果：本综述包括发表的20项研究。七项研究仅用于体外分析，而13项研究同时进行了体外和体内分析。体内研究采用动物模型，包括163只C57BL6小鼠和73只Sprague-Dawley大鼠。在骨缺损的动物模型中,发现源自M2巨噬细胞的外来体在促进骨再生和血管形成方面是有效的。这些作用主要通过形态学和组织学评估得到证实。这一显著的结果归因于多种信号通路的调节，11项研究研究miRNAs参与这一复杂过程的结果证明了这一点。此外,体外研究观察到对细胞增殖的积极影响，迁移,成骨,和血管生成。研究方法的异质性阻碍了研究结果的直接比较。
结论：M2巨噬细胞衍生的外泌体显示出促进骨再生的显著潜力。进一步研究优化其应用并阐明其潜在机制可以为临床翻译铺平道路。
方法：在PubMed的2020年至2024年之间进行的全面搜索，WebofScience,使用确定的搜索策略进行Scopus，以确定有关以下问题的相关研究：“M2巨噬细胞衍生的外泌体对骨再生有什么影响？”本研究包括体外和体内对照研究。SYRCLE工具用于评估纳入动物研究中的偏倚风险。
结果：本综述包括发表的20项研究。七项研究仅用于体外分析，而13项研究同时进行了体外和体内分析。体内研究采用动物模型，包括163只C57BL6小鼠和73只Sprague-Dawley大鼠。在骨缺损的动物模型中,发现源自M2巨噬细胞的外来体在促进骨再生和血管形成方面是有效的。这些作用主要通过形态学和组织学评估得到证实。这一显著的结果归因于多种信号通路的调节，11项研究研究miRNAs参与这一复杂过程的结果证明了这一点。此外,体外研究观察到对细胞增殖的积极影响，迁移,成骨,和血管生成。研究方法的异质性阻碍了研究结果的直接比较。
结论：M2巨噬细胞衍生的外泌体显示出促进骨再生的显著潜力。进一步研究优化其应用并阐明其潜在机制可以为临床翻译铺平道路。
