Exosomes in Intervertebral Disc Regeneration: Roles, Opportunities, and Challenges

Intervertebral disc degeneration (IVDD), a major cause of low back pain, poses significant global health and socioeconomic challenges. Current therapies have limited effectiveness in reversing degeneration, which underscores the need for advanced treatment strategies. Exosomes, which are nanoscale extracellular vesicles, have emerged as promising therapeutic agents for IVDD due to their unique biological properties. They exert their effects through multiple mechanisms, such as regulating the extracellular matrix, promoting cell proliferation, and exerting anti‐inflammatory effects. This review summarizes recent advances in exosome‐based therapies for IVDD. It encompasses their mechanisms, cell sources, engineering technologies, and progress in clinical translation. Additionally, the challenges and opportunities related to their future clinical application are discussed, and their potential to revolutionize the treatment of IVDD is highlighted.