Extracellular vesicle therapy for the treatment of bone resorption: Systemic review and meta-analysis

Abstract

Chronic inflammatory diseases can lead to loss of bone homeostasis culminating in bone disorders characterized by increased bone resorption. Several therapies have been proposed for the treatment of these diseases; however, due to undesirable side effects, the search for new approaches to eliminate these inconveniences has been the focus of numerous scientific studies. Extracellular vesicles (EVs) proposed in treatments linked to regenerative medicine have shown promising results and may represent an alternative for the treatment of bone resorption. Therefore, studying the effectiveness of the use of EVs for the treatment of bone resorption and comparing it with existing clinical approaches is essential for future clinical protocols. Therefore, this research aims to analyze, through a systematic review, the effectiveness of therapy with EVs for the treatment of bone resorption in comparison with established protocols and approaches. For this, the study will be conducted by the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The electronic literature search will be carried out until December 2023 using the PubMed/MEDLINE, Scopus, and Cochrane Library databases to answer the PICO question: "Would therapy with extracellular vesicles be efficient for the treatment of bone resorption?" Control of bone resorption will be considered the primary outcome. The molecular mechanisms and cell types participating in the inhibition and control of bone resorption will be included in secondary outcomes. Also, the dosage, the route of administration, and the form of extraction of the EVs and the source cells of EVs will be investigated. After selecting the articles and extracting the data considering the aforementioned outcomes, the extracted data will be submitted to bias analysis and meta-analysis. It is expected to determine which is the best therapy to be used for the treatment of disorders associated with bone resorption.