Role of mesenchymal stem cell-derived exosomal non-coding RNAs in bone and bone-related disorders

Mesenchymal stem cells (MSCs) are known for their ability to differentiate into various cell lineages, including osteoblasts (bone-forming cells), and for their significant paracrine effects. Among their secreted products, exosomes have gained considerable attention as nanoscale carriers of bioactive molecules such as non-coding RNAs (ncRNAs). These ncRNAs, including microRNAs, long ncRNAs, and circular ncRNAs, are critical regulators of gene expression and cellular functions. Moreover, MSC-derived exosomes not only offer advantages such as targeted delivery, reduced immunogenicity, and protection of cargo material, but also carry ncRNAs that have therapeutic and diagnostic potential in bone-related disorders. Emerging evidence has highlighted the role of MSC-derived exosomal ncRNAs in osteogenesis, bone remodeling, and intercellular signaling in the bone microenvironment. This review consolidates recent research on the role of MSC-derived exosomal ncRNAs in maintaining bone homeostasis and bone-related disorders <i>via</i> various signaling pathways and epigenetic modifications. Furthermore, we explore the therapeutic potential of MSC-derived exosomal ncRNAs as biomarkers and therapeutic targets. This comprehensive review offers key insights into the regulatory roles of MSC-derived exosomal ncRNAs in bone biology and their clinical significance in bone-related diseases.