Inflammatory Fibroblast‐Like Synoviocyte‐Derived Exosomes Aggravate Osteoarthritis via Enhancing Macrophage Glycolysis (Adv. Sci. 14/2024)

Fibroblast-Like Synoviocytes The cover shows blooming lotus flowers, with the pollen from one flower being spread to another by butterflies, which is a metaphor for the phenomenon the authors discovered in the synovium of osteoarthritis. In article number 2307338, Baosheng Guo, Qing Jiang, and co-workers reveal that the inflammatory fibroblast-like synoviocytes (FLSs) secret more exosomes compared to intact FLSs. The exosomes derived from inflammatory FLSs act as the butterflies, spreading inflammation from FLSs to macrophages, further triggering macrophage M1-like polarization and aggravating osteoarthritis. This study reveals the aberrant intercellular communication mediated by exosomes in the pathogenesis of synovitis, of which the mechanism involves the activation of glycolysis in macrophages by upregulating the transcription factor HIF1A, providing a new avenue for us to explore therapeutic approaches for osteoarthritis in the future.