Multi-omics analysis of small extracellular vesicles in osteoarthritis: bridging the gap between molecular insights and clinical applications

Osteoarthritis (OA) is a prevalent degenerative joint disorder with significant socioeconomic impact. Despite advances in understanding its pathophysiology, current therapeutic strategies remain largely palliative. Small extracellular vesicles (sEV) have emerged as crucial mediators of intercellular communication in joint tissues, offering new insights into OA pathogenesis and potential therapeutic targets. This review explores the application of multi-omics approaches to sEV research in OA, assessing how these advanced technologies are contributing to our understanding of the disease and their potential to revolutionize OA management. We discuss the latest findings on the role of sEV in OA, the applications of multi-omics technologies in deciphering sEV cargo, the progress toward clinical translation, and the challenges and opportunities in this field. By synthesizing current knowledge and identifying key research gaps, this review provides a roadmap for leveraging sEV multi-omics to bridge the gap between molecular discoveries and clinical applications in OA.