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Exosomes derived from bone marrow mesenchymal stem cells (BMSCs\u2010Exos) promote M2 polarization and inhibit M1 polarization of macrophages. However, clinical application problems such as easy clearance and lack of targeting exist. Exosomes derived from M2 macrophages (M2\u2010Exos) have good biocompatibility, immune escape ability, and natural inflammatory targeting ability. M2\u2010Exos and BMSCs\u2010Exos fused exosomes (M2\u2010BMSCs\u2010Exos) are constructed, which targeted the osteolysis site and exerted the therapeutic effect of both exosomes. M2\u2010BMSCs\u2010Exos achieved targeted osteolysis after intravenous administration inhibiting M1 polarization and promoting M2 polarization to a greater extent at the targeted site, ultimately playing a key role in the prevention and treatment of aseptic loosening of prostheses. In conclusion, M2\u2010BMSCs\u2010Exos can be used as a precise and reliable molecular drug for peri\u2010prosthetic osteolysis. Fused exosomes M2\u2010BMSCs\u2010Exos \u00a0were originally proposed and successfully prepared, and exosome fusion technology provides a new theoretical basis and solution for the clinical application of therapeutic exosomes.<\/jats:p>","DOI":"10.1002\/smll.202303506","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T23:35:22Z","timestamp":1697067322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Enhanced Osteolysis Targeted Therapy through Fusion of Exosomes Derived from M2 Macrophages and Bone Marrow Mesenchymal Stem Cells: Modulating Macrophage Polarization"],"prefix":"10.1002","volume":"20","author":[{"given":"Tianliang","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Orthopedics Xiangya Hospital Central South University  Changsha 410008 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Diagnosis Second Xiangya Hospital Central South University  Changsha 410012 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Xiangya Hospital Central South University  Changsha 410008 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuailong","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Xiangya Hospital Central South University  Changsha 410008 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Diagnosis Second Xiangya Hospital Central South University  Changsha 410012 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qimeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanzhi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yute","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihe","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8042-0600","authenticated-orcid":false,"given":"Jie","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou 310003 China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,8]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.03.066"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-010-9356-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8122091"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.gt.3302192"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/gt.2010.64"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/2047-1440-1-12"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01408"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.28609"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-022-02975-0"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-015-0642-6"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bioactmat.2021.02.005"},{"key":"e_1_2_10_12_1","first-page":"779","volume":"12","author":"Monopoli M. 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