细胞外囊泡在骨质疏松发生与治疗中的作用及其功能化递送策略

doi:10.3969/j.issn.1674-8115.2026.09.003

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (9): 1179-1187.doi: 10.3969/j.issn.1674-8115.2026.09.003

• 前沿述评 • 上一篇

细胞外囊泡在骨质疏松发生与治疗中的作用及其功能化递送策略

张鑫¹^,², 李丹¹^,³, 杨菊¹^,³, 邓科蕾⁴, 曹宏¹^,²^,³^,⁵()

^1.江南大学附属医院营养科，功能食品临床评价中心，无锡 214122
^2.江南大学无锡医学院，无锡 214122
^3.江苏集萃未来食品技术研究所有限公司，宜兴 214213
^4.浙江大学医学院附属儿童医院外科重症监护室，杭州 310051
^5.江南大学附属医院内分泌科，无锡 214122

收稿日期:2025-12-04 接受日期:2026-02-02 出版日期:2026-09-28 发布日期:2026-09-28
通讯作者: 曹　宏，教授，博士；电子信箱：hongcao@jiangnan.edu.cn。
基金资助:
无锡市2025年软科学研究课题(KX-25-C166)

Roles of extracellular vesicles in pathogenesis and treatment of osteoporosis and their functionalized delivery strategies

Zhang Xin¹^,², Li Dan¹^,³, Yang Ju¹^,³, Deng Kelei⁴, Cao Hong¹^,²^,³^,⁵()

^1.Department of Nutrition, Clinical Evaluation Center for Functional Foods, Affiliated Hospital of Jiangnan University, Wuxi 214122, China
^2.Wuxi Medical College of Jiangnan University, Wuxi 214122, China
^3.Jiangsu Jicui Future Food Technology Research Institute Co. , Ltd. , Yixing 214213, China
^4.Department of Surgical ICU, Children′s Hospital, Zhejiang University School of Medicine, Hangzhou 310051, China
^5.Department of Endocrinology, Affiliated Hospital of Jiangnan University, Wuxi 214122, China

Received:2025-12-04 Accepted:2026-02-02 Online:2026-09-28 Published:2026-09-28
Contact: Cao Hong, E-mail: hongcao@jiangnan.edu.cn.
Supported by:
Wuxi Municipal Soft Science Research Project for 2025(KX-25-C166)

摘要/Abstract

摘要：

骨质疏松症以骨量丢失和微结构破坏为特征，已成为降低全球中老年人生活质量并加剧社会经济负担的系统性骨病。细胞外囊泡（extracellular vesicles，EVs）是细胞间信息传递的重要载体，内含蛋白质、脂质及核酸等多种活性分子，在骨重塑平衡中发挥关键作用。EVs既能推动成骨细胞分化，又能抑制破骨细胞活性，并刺激血管新生，因而在骨质疏松治疗中显示出潜力。然而，天然EVs在体内清除快、靶向弱等固有缺陷限制了其临床转化。为突破上述瓶颈，多种功能化策略相继出现。该文梳理EVs的基本特性与生物学行为，解析其在骨微环境中的多重调控机制；聚焦骨质疏松治疗新思路，探讨如何通过细胞预处理提升天然EVs活性，借助内容物工程和表面修饰增强工程化EVs的效能和靶向性，以及将后者与水凝胶或3D打印支架等智能材料耦合，构建可局部滞留、可控释放并协同促修复的递送体系；总结该领域面临的挑战，展望EVs用于骨质疏松精准治疗的前景，为开发高效、安全的无细胞骨再生疗法提供理论依据与研究视角。

关键词: 骨组织工程, 细胞外囊泡, 骨质疏松, 骨再生

Abstract:

Osteoporosis is a systemic skeletal disease characterized by reduced bone mass and disrupted bone microarchitecture, representing a major cause of disability and diminished quality of life among middle-aged and older adults while imposing a substantial socioeconomic burden worldwide. Extracellular vesicles (EVs) are membrane-bound nanoparticles that mediate intercellular communication by transferring proteins, lipids, and nucleic acids between cells. In the skeletal system, EVs participate in multiple stages of bone remodeling by promoting osteogenic differentiation, inhibiting osteoclast formation and function, and regulating angiogenesis, making them promising candidates for osteoporosis therapy. Nevertheless, the therapeutic application of native EVs is restricted by rapid clearance after administration and limited bone-targeting efficiency. Recent advances in EV engineering have provided new opportunities to address these limitations. This review summarizes the biological characteristics of EVs and discusses their regulatory roles in the bone microenvironment. It further focuses on emerging strategies for EV-based osteoporosis therapy, including donor-cell preconditioning to improve the biological activity of native EVs, cargo engineering and surface modification to enhance therapeutic efficacy and bone-targeting capability, and the combination of engineered EVs with biomaterial platforms such as hydrogels and three-dimensional printed scaffolds to construct delivery systems that enable localized retention, controlled release, and synergistic tissue repair. Finally, the current challenges associated with EV-based therapeutics and the prospects for their clinical translation are discussed. This review provides a theoretical basis and research perspective for the development of effective and safe cell-free bone regeneration therapies.

Key words: bone tissue engineering, extracellular vesicle (EV), osteoporosis, bone regeneration

中图分类号:

R318

张鑫, 李丹, 杨菊, 邓科蕾, 曹宏. 细胞外囊泡在骨质疏松发生与治疗中的作用及其功能化递送策略[J]. 上海交通大学学报（医学版）, 2026, 46(9): 1179-1187.

Zhang Xin, Li Dan, Yang Ju, Deng Kelei, Cao Hong. Roles of extracellular vesicles in pathogenesis and treatment of osteoporosis and their functionalized delivery strategies[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026,(9): 1179-1187.

图/表 1

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细胞外囊泡在骨质疏松发生与治疗中的作用及其功能化递送策略

Roles of extracellular vesicles in pathogenesis and treatment of osteoporosis and their functionalized delivery strategies

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