Publication Name	World Journal of Stem Cells
Manuscript ID	119231
Country	China

Category	Orthopedics
Manuscript Type	Opinion Review
Article Title	GrpE-like 1-engineered synovial mesenchymal stromal cell exosomes: Mechanistic and translational priorities in osteoarthritis
Manuscript Source	Unsolicited Manuscript
All Author List	Zhen Shi, Hao-Yu Li, Bo-Kang Lv, Dong Li, Peng-Yu Lu, Xin-Yu Zhou, Meng-En Xue and Rui-Bo Wang
Funding Agency and Grant Number	Funding Agency Grant Number Key Scientific Research Projects of Colleges and Universities in Henan Province 26A320038 Henan Province Medical Science and Technology Research Plan Project (Joint Construction) LHGJ20250403, LHGJ20220566, LHGJ2024036 Key Research and Development Program of Henan Province 231111311000 Medical Education Research Project in Henan Province WJLX2023079
Corresponding Author	Rui-Bo Wang, Associate Chief Physician, MD, Second Department of Orthopedics, The Fifth Affiliated Hospital of Zhengzhou University, No. 3 Kangfu Qian Street, Erqi District, Zhengzhou 450052, Henan Province, China. 18336397518@163.com
Key Words	Cartilage regeneration; Engineered exosomes; GrpE-like 1; Mesenchymal stromal cells; Mitophagy; Mitochondrial homeostasis; Mitochondrial quality control; Osteoarthritis; Phosphatase and tensin homolog-induced kinase 1; Translational therapeutics
Core Tip	Osteoarthritis still lacks reliable disease-modifying therapies. This review highlights an emerging mitochondria-centered strategy in which synovial mesenchymal stem cell-derived exosomes deliver GrpE-like 1 to engage the phosphatase and tensin homolog-induced kinase 1-dependent mitophagy pathway, improving mitochondrial homeostasis and cartilage outcomes across in vitro and in vivo models. We synthesize the mechanistic rationale and delineate the minimal translational checkpoints required for clinical readiness: Flux-based and specificity-anchored causal validation, chemistry, manufacturing, and controls - standardized product definition with mechanism-linked potency assays, and intra-articular pharmacokinetics/pharmacodynamics coupled to biomarker-driven patient stratification.
Citation	Shi Z, Li HY, Lv BK, Li D, Lu PY, Zhou XY, Xue ME, Wang RB. GrpE-like 1-engineered synovial mesenchymal stromal cell exosomes: Mechanistic and translational priorities in osteoarthritis. World J Stem Cells 2026; In press

Received	2026-01-22 02:50
Peer-Review Started	2026-01-22 02:53
First Decision by Editorial Office Director	2026-01-30 08:59
Return for Revision	2026-01-30 08:59
Revised	2026-02-09 19:11
Publication Fee Transferred
Second Decision by Editor	2026-04-15 02:41
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-22 09:06
Articles in Press	2026-04-22 09:06
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-0210 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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