Los exosomas son una nueva estrategia terapéutica para la mejoría del dolor lumbar. Revisión de la literatura

Low back pain is a common and debilitating health issue that affects a significant portion of the global population. One of the primary factors contributing to this pain is the degenerative deterioration of the intervertebral discs, which is characterized by an imbalance between anabolic and catabolic processes, leading to the degradation of the extracellular matrix, inadequate hydration of the nucleus pulposus, and cell death due to inflammation and oxidative stress. While various treatments for low back pain are available, none of them is entirely curative. Thus, new therapeutic options have been developed to halt and reverse the degenerative processes involved, such as the use of exosomes. To assess the efficacy of these innovative therapies, an extensive review of the existing English-language literature was conducted, encompassing experimental studies in vitro or in vivo, systematic reviews, and randomized controlled trials. The results of this review revealed seven distinct cell groups that have been employed in the production of exosomes, demonstrating promising biological indications in the management of degenerative disc disease Each of these cell groups has been thoroughly investigated in both in vivo and in vitro models, and while only platelet-rich plasma has been subjected to clinical trials, the experimental and clinical results are encouraging. It is important to acknowledge that further studies are required to refine this information and establish optimal protocols for clinical use. Nonetheless, it is essential to adopt a new perspective when treating patients with low back pain, recognizing that only the implementation of regenerative therapies and a modification of risk factors could enable improved long-term outcomes. In conclusion, randomized controlled clinical trials are needed to evaluate comprehensively the effectiveness of these treatments and determine their appropriate role in the management of degenerative disc disease.