Exosomes and exosomal miRNAs: A new avenue for the future treatment of rheumatoid arthritis

Abstract

Rheumatoid arthritis is a chronic systemic autoimmune disease that involves mainly synovitis and joint injury and is one of the main causes of disability. The pathogenesis of rheumatoid arthritis is complicated, and the treatment cycle is long. The traditional methods of inhibiting inflammation and immunosuppression are no longer sufficient for treatment of the disease, so there is an urgent need to seek new treatments. The exocrine microenvironment is a kind of microvesicle with a lipid bilayer membrane structure that can be secreted by most cells in the body. This structure contains cell-specific proteins, lipids and nucleic acids that can transmit this information from one cell to another. To achieve cell-to-cell communication. Exocrine microRNAs can be contained in exocrine cells and can be selectively transferred to target receptor cells via exocrine signaling, thus regulating the physiological function of target cells. This article focuses on the pathological changes that occur during the development of rheumatoid arthritis and the biological regulation of exocrine and exocrine microRNAs in rheumatoid joints. Research on the roles of exocrine and exocrine microRNAs in regulating the inflammatory response, cell proliferation/apoptosis, autophagy, effects on fibroblast-like synoviocytes and immune regulation in rheumatoid arthritis was reviewed. In addition, the challenges faced by this new treatment are discussed.

Keywords: Exosome mRNAs; Exosomes; Immunity; Mechanism of action; Rheumatoid arthritis.

Fig. 1

Five common pathogeneses leading to the occurrence and development of rheumatoid arthritis. APC, antigen-presenting cell; ROS, reactive oxygen species; TH, helper T cell; COX-2, cyclooxygenase-2; PGs, prostaglandins; LTs, leukotrienes; NLRs, Nod-like receptors; FLS, fibroblast-like synoviocytes; MMPS, matrix metalloproteinases (created with BioRender.com).

Fig. 2

Biogenesis and biological characteristics of exosomes. Exosomes are secreted and generated by extracellular vesicles with a lipid bilayer in which a variety of transmembrane proteins, such as CD9, CD63, CD37, CD81, and CD82, and heat shock proteins, such as Hsp60 and Hsp70, are present and are able to perform multiple immune functions. These genes are involved in the regulation of gene transcription and translation, homeostasis of the immune response, regulation of central and peripheral immunity, antigen presentation, etc. (created with BioRender.com).

Fig. 3

Exosomes and exosomal miRNAs ameliorate RA by regulating local oxidative stress, the inflammatory response, angiogenesis, and cellular autophagy in joints.

Fig. 4

Mesenchymal stem cell-derived exosomes as immunomodulatory carriers in the treatment of disease (generated with BioRender.com).