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The development of osteoporosis is closely associated with the disruption of this balance. Muscles and bones, integral components of the musculoskeletal system, are functionally interconnected, and the onset of osteoporosis is frequently linked to the decline in skeletal muscle function. Exosomes play a crucial role in facilitating chemical information exchange between muscles and bones. This study aims to elucidate the effects of skeletal muscle-derived exosomes on bone formation and resorption, investigate their therapeutic potential for osteoporosis, and propose novel strategies for osteoporosis treatment and targeted drug development. The Translational Potential of this Article: This study investigated the potential of skeletal muscle-derived exosomes in osteoporosis treatment, elucidating their critical role in modulating bone formation and resorption. By clarifying the interaction mechanisms between muscle and bone mediated by exosomes, this research laid a theoretical foundation for novel therapeutic strategies. Therapies based on serve as more targeted and efficient interventions with fewer side effects, thereby advancing the field of bone tissue engineering and offering new prospects for the prevention and management of osteoporosis.<\/jats:p>","DOI":"10.1186\/s12967-025-07315-3","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:03:51Z","timestamp":1763463831000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Roles of skeletal muscle-derived exosomes in osteoporosis"],"prefix":"10.1186","volume":"23","author":[{"given":"Yuting","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaihong","family":"Weng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiquan","family":"Weng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1032-6330","authenticated-orcid":false,"given":"Yu","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"7315_CR1","doi-asserted-by":"crossref","unstructured":"Jia Z, Zhang S, Li W. 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