Exosome-Delivered Factors and Their Influence on Angiogenic Processes in Bone Healing Publisher



Emami A ; Oskouie IM
Source: Regenerative Engineering and Translational Medicine Published:2026

Abstract

Abstract: Exosome-based therapies have emerged as a promising approach to enhance angiogenesis and promote bone healing, offering novel strategies for treating bone defects and fractures. Exosomes, small extracellular vesicles that carry proteins, lipids, and RNA molecules, play a crucial role in intercellular communication and tissue regeneration. In bone healing, angiogenesis— the formation of new blood vessels— is essential for providing oxygen, nutrients, and growth factors to the injured area, and is closely linked to osteogenesis, the formation of new bone tissue. Exosome-delivered factors, including angiogenic proteins such as VEGF and FGF, miRNAs, and lipids, regulate endothelial cell behavior, promoting blood vessel formation and supporting bone regeneration. While preclinical studies have shown that exosome-derived factors can enhance vascularization and accelerate tissue repair, challenges such as exosome stability, efficient delivery, and large-scale production remain significant hurdles. This review explores the molecular mechanisms through which exosomes influence angiogenesis during bone healing, discussing the specific roles of exosomal proteins, RNAs, and lipids in vascularization and tissue repair. We also examine the therapeutic potential of exosome-based therapies for enhancing bone regeneration and their future clinical applications in regenerative medicine. Lay Summary: Bone healing requires the formation of new blood vessels to supply oxygen and nutrients to damaged tissue. Recent research has shown that exosomes—tiny vesicles released by cells—play an important role in this process. Exosomes carry biologically active molecules such as proteins, RNA, and lipids that help cells communicate and coordinate tissue repair. In bone regeneration, exosome-delivered factors can stimulate the growth of new blood vessels, which in turn supports the formation of new bone. This review explains how exosomes influence blood vessel formation during bone healing and discusses their potential as a future therapeutic strategy for treating bone defects and fractures. © The Author(s), under exclusive licence to The Regenerative Engineering Society 2026.