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First, we successfully obtained EC-exos through differential centrifugation. Then, the effects of EC-exos on mouse embryo osteoblast precursor (MC3T3-E1) cells under high concentration of dexamethasone (Dex) were analysed in vitro, which included cell migration, viability, and apoptosis. In vivo, a SNFH rat model was successfully established and treated with EC-exos. Micro-computed tomography (micro-CT) and haematoxylin and eosin (H&amp;E) were used to observe femoral trabeculae. Our in vitro results showed that EC-exos improved cell viability and migration of osteoblasts and reduced the apoptotic effect of high concentration of Dex on osteoblasts in vitro. Phosphoinositide 3-kinase (PI3K)\/Akt\/Bcl-2 signalling pathway was activated in MC3T3-E1 cells under the response to EC-exos. In vivo, increased bone volume per tissue volume (BV\/TV) <jats:inline-formula><a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><a:mfenced open=\"(\" close=\")\" separators=\"|\"><a:mrow><a:mi>p<\/a:mi><a:mo>=<\/a:mo><a:mn>0.031<\/a:mn><\/a:mrow><\/a:mfenced><\/a:math><\/jats:inline-formula>, trabecular thickness (Tb.Th) <jats:inline-formula><f:math xmlns:f=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><f:mfenced open=\"(\" close=\")\" separators=\"|\"><f:mrow><f:mi>p<\/f:mi><f:mo>=<\/f:mo><f:mn>0.020<\/f:mn><\/f:mrow><\/f:mfenced><\/f:math><\/jats:inline-formula>, and decreased separation (Tb.Sp) <jats:inline-formula><k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><k:mfenced open=\"(\" close=\")\" separators=\"|\"><k:mrow><k:mi>p<\/k:mi><k:mo>=<\/k:mo><k:mn>0.040<\/k:mn><\/k:mrow><\/k:mfenced><\/k:math><\/jats:inline-formula> were observed in SNFH rats treated with EC-exos. H&amp;E staining revealed fewer empty lacunae and pyknotic osteocytes in trabeculae. The expression of Bcl-2 and Akt in EC-exos group was significantly increased in trabeculae tissue. Overall, our finding indicated that EC-exos could attenuate SNFH by inhibiting osteoblast apoptosis via the PI3K\/Akt\/Bcl-2 pathway.<\/jats:p>","DOI":"10.1155\/2024\/3870988","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T01:50:20Z","timestamp":1715392220000},"page":"1-11","source":"Crossref","is-referenced-by-count":3,"title":["Endothelial Cell-Derived Exosomes Inhibit Osteoblast Apoptosis and Steroid-Induced Necrosis of Femoral Head Progression by Activating the PI3K\/Akt\/Bcl-2 Pathway"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8624-0245","authenticated-orcid":true,"given":"Jie","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Affiliated 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