MiR-150-5p-modified Bone Marrow Mesenchymal Stem Cells Derived Exosomes Ameliorate Osteonecrosis of Femoral Head by Promoting Endothelial Cell Angiogenesis

Background: Osteonecrosis of femoral head (ONFH) is a common ischemic disease that induces femoral head necrosis. The role of exosomes and miRNA in ONFH has been elucidated, however, whether miRNA-modified exosomes improve the therapy of ONFH is not clear.Methods: We screened ONFH-related miRNAs by RNA sequencing in plasma exosomes of ONFH patients and healthy donors. The key miRNA was overexpressed in bone marrow mesenchymal stem cells (BMSC) exosomes. The regulatory functions of miRNA-modified BMSC exosomes in vascular endothelial cells were illustrated through angiogenesis assay and scratch assay.Results: We identified 9 differently expressed miRNAs (DEmiRNAs) in plasma exosomes between ONFH and healthy groups, with 6 up-regulated and 3 down-regulated miRNAs. Function and pathway analysis revealed DEmiRNAs were primarily involved in angiogenesis, cell migration, focal adhesion. Moreover, miR-150-5p was declined in ONFH exosomes and regulated multiple angiogenesis-related pathways. The miR-150-5p-overexpressed BMSC exosomes were successfully obtained and transported miR-150-5p to endothelial cells. Moreover, the miR-150-5p-modified BMSC exosomes promoted the angiogenesis and migration of endothelial cells.Conclusion: Our results elucidate the exosomal miRNA expression profiles in ONFH, and miR-150-5p-modified BMSC exosomes protect against ONFH by promoting angiogenesis, suggesting a new molecular knowledge for the clinical application of ONFH.