Lim YJ, Seo MS, Park S, Lee GW. Therapeutic strategies for intervertebral disc degeneration: Extracellular vesicles and microRNAs derived from mesenchymal stem cells. World J Stem Cells 2025; 17(7): 107212 [DOI: 10.4252/wjsc.v17.i7.107212]
Corresponding Author of This Article
Gun Woo Lee, MD, PhD, Associate Professor, Department of Orthopedic Surgery, Yeungnam University College of Medicine, No. 170 Hyunchung-ro, Namgu, Daegu 42415, South Korea. gwlee1871@gmail.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Stem Cells. Jul 26, 2025; 17(7): 107212 Published online Jul 26, 2025. doi: 10.4252/wjsc.v17.i7.107212
Therapeutic strategies for intervertebral disc degeneration: Extracellular vesicles and microRNAs derived from mesenchymal stem cells
Young-Ju Lim, Min-Soo Seo, Sangbum Park, Gun Woo Lee
Young-Ju Lim, Gun Woo Lee, Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu 42415, South Korea
Min-Soo Seo, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, South Korea
Sangbum Park, Michigan State University, Institute for Quantitative Health Science & Engineering, East Lansing, MI 48824, United States
Sangbum Park, Department of Medicine, Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, United States
Gun Woo Lee, Department of Medicine, Institute for Quantitative Health Science & Engineering, East Lansing, MI 48824, United States
Co-first authors: Young-Ju Lim and Min-Soo Seo.
Author contributions: Lim YJ and Seo MS performed the research and wrote the manuscript, they contributed equally to this article and are co-first authors of this manuscript; Park S validated and interpreted the literature; Lee GW designed the research study and approved final version of the manuscript. All authors have read and approved the final manuscript.
Supported by 2024 Yeungnam University Grant, No. 224A480005.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gun Woo Lee, MD, PhD, Associate Professor, Department of Orthopedic Surgery, Yeungnam University College of Medicine, No. 170 Hyunchung-ro, Namgu, Daegu 42415, South Korea. gwlee1871@gmail.com
Received: March 18, 2025 Revised: April 15, 2025 Accepted: June 17, 2025 Published online: July 26, 2025 Processing time: 128 Days and 18 Hours
Abstract
Intervertebral disc degeneration (IDD) results from an imbalance within the intervertebral disc, leading to alterations in extracellular matrix composition, loss of nucleus pulposus cells, increased oxidative stress, and inflammatory cascade. While IDD naturally progresses with age, some factors such as mechanical trauma, lifestyle choices, and genetic abnormalities can elevate the risk of symptomatic disease progression. Current treatments, including pharmacological and surgical interventions, fail to halt disease progression or restore IDD function. Although biological therapies have been evaluated, their effectiveness in reversing long-term disc degeneration remains inconsistent. Mesenchymal stem cell-based therapies have demonstrated potential for IDD regeneration but are hindered by biological limitations, ethical issues, etc. To date, mesenchymal stem cell-derived extracellular vesicles (EVs) have emerged as promising therapeutic agents for regeneration and anti-inflammation. Their therapeutic effects are attributed to several mechanisms, such as the induction of regenerative phenotype, apoptosis mitigation, and immunomodulation. In addition, the abundance of microRNAs within EVs play a crucial role in modulating the disc degeneration. Due to the problems in clinical use, however, the efficiency of the EVs should be overcome further by optimizing cell culture conditions, engineering them to deliver drugs and targeting molecules, etc.
Core Tip: Intervertebral disc degeneration (IDD) has been focused on the condition that is linked to several pathological condition, but no effective treatment has been reported so far. Due to the limitations of mesenchymal stem cell-based trials for IDD regeneration, extracellular vesicle or microRNAs derived from mesenchymal stem cell have been evaluated as the next generation of therapeutic option for IDD. Thus, this review aims to provide a comprehensive overview regarding the IDD including anatomical considerations and therapeutic trials with a particular focus on extracellular vesicles and microRNAs. The authors also discuss the challenges and future directions in translating these innovative therapies into clinical practice.
