Evidence map›Paper›PMID 41689665›Full record

ReviewClinical and experimental medicine2026

The immunomodulatory power of mesenchymal stem/stromal cell-derived extracellular vesicles in bone disorders: A comprehensive review.

Armin Akbarzadeh, Majid Reza Farrokhi, Mohammad Ayati Firoozabadi, Seyed Mohammad Javad Mortazavi, Javad Mortazavi, Sina Vakili, Shima Shapoori, Morteza Jafarinia

Abstract readReview
In one paragraph

Review in Clinical and experimental medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Armin AkbarzadehDepartment of Orthopedic Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Majid Reza FarrokhiShiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Mohammad Ayati FiroozabadiJoint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Mohammad Javad MortazaviJoint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Javad MortazaviJoint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Sina VakiliInfertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Shima ShapooriCÚRAM Research Ireland Centre for Medical Devices, University of Galway, Galway, Ireland.
Morteza JafariniaShiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. jafarinia@sums.ac.ir.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Bones are not only mechanical structures but also highly active immunological organs. The bone marrow hosts hematopoietic, mesenchymal, and immune cells that continuously interact to coordinate bone remodeling, hematopoiesis, and systemic immune responses. Disruption of this osteoimmune network contributes to pathological conditions such as delayed fracture healing, osteoporosis, osteoarthritis, osteomyelitis, and other bone-destructive disorders. Mesenchymal stem/stromal cell-derived extracellular vesicles (MSC-EVs) have emerged as key paracrine mediators and promising therapeutic candidates within this system. In this review, we summarize current knowledge on the biogenesis, composition, and characterization of MSC-EVs, and then focus on how they modulate macrophages, neutrophils, T and B cells, natural killer (NK) cells, and other stromal populations in the bone microenvironment. We discuss preclinical evidence across major bone disorders, including fracture repair, osteoporosis, osteoarthritis, osteonecrosis, periodontitis, and osteomyelitis, emphasizing the immunomodulatory mechanisms involved (e.g., regulation of M1/M2 balance, Th17/Treg ratios, neutrophil extracellular traps, and NK cell activity). Finally, we outline translational progress, including early clinical studies, manufacturing and potency-assay challenges, and outstanding questions that must be addressed to integrate MSC-EVs into future therapeutic strategies for bone disease.

Indexed as

Bone DiseasesExtracellular VesiclesImmunomodulationMesenchymal Stem CellsAnimalsHumansBone regenerationExosomesExtracellular vesiclesImmunomodulationMesenchymal stem/Stromal cells

Identifiers

PMID41689665
PMCPMC12909371

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.