Review
Immunology
Geir Bjorklund, Maksim Pivin, Tony Hangan, Oksana Yurkovskaya, Lyudmila Pivina
Summary: This paper analyzes the clinical manifestations of autoimmune polyendocrine syndrome type 1, including its genetic pathophysiology, epidemiology, and current management.
AUTOIMMUNITY REVIEWS
(2022)
Article
Genetics & Heredity
Ya-Bing Wang, Ou Wang, Min Nie, Yan Jiang, Mei Li, Wei-Bo Xia, Xiao-Ping Xing
Summary: This study described the phenotypes and genetic characterization of Chinese patients with APS1, revealing both common and less commonly observed manifestations. Several unique AIRE mutations were identified in the patients, expanding the genetic spectrum for future research on the pathogenesis of APS1.
ORPHANET JOURNAL OF RARE DISEASES
(2021)
Article
Cell Biology
Guofeng Qian, Xiaoyi Yan, Junli Xuan, Danfeng Zheng, Zhiwen He, Jianguo Shen
Summary: In this study, we reported a case of APS-1 and identified a novel mutation in the AIRE gene. Our findings contribute to the enrichment of the AIRE mutation database and further understanding of APS-1.
FRONTIERS IN CELL AND DEVELOPMENTAL BIOLOGY
(2022)
Article
Endocrinology & Metabolism
JiaQi Chen, Ting Lu, ChenXiao Liu, Yun Zhao, AiJie Huang, XingNa Hu, Min Li, Rong Xiang, Min Feng, HongHong Lu
Summary: This case report describes a 20-year-old male diagnosed with APS-1 and presenting with symptoms of diabetes insipidus. Through whole-exome sequencing (WES), a novel compound heterozygous mutation in the AIRE gene was identified, expanding the understanding of mutations associated with APS-1.
BMC ENDOCRINE DISORDERS
(2021)
Article
Endocrinology & Metabolism
Elisa Gatta, Valentina Anelli, Elena Cimino, Elena Di Lodovico, Elda Piovani, Irene Zammarchi, Giorgia Gozzoli, Virginia Maltese, Maria Cavadini, Barbara Agosti, Andrea Delbarba, Ilenia Pirola, Angela Girelli, Caterina Buoso, Francesca Bambini, Daniele Alfieri, Walter Bremi, Paolo Facondo, Roberto Lupo, Francesco Bezzi, Micaela Fredi, Anna Maria Mazzola, Elena Gandossi, Maura Saullo, Fiorella Marini, Massimo Licini, Letizia Chiara Pezzaioli, Laura Pini, Franco Franceschini, Chiara Ricci, Carlo Cappelli
Summary: This monocentric observational retrospective study characterized patients with APS type 4 diagnosed and monitored at a local Reference Center. The prevalence of APS type 4 was found to be 9:100,000 people. Type I diabetes mellitus was the leading indicator of APS type 4, and 50% of patients developed the condition within the first ten years. 5% of female patients developed premature ovarian failure.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Treena Cranston, Hannah Boon, Mie K. Olesen, Fiona J. Ryan, Deborah Shears, Rosemary London, Hussam Rostom, Taha Elajnaf, Rajesh Thakker, Fadil M. Hannan
Summary: This study investigated over 300 probands with suspected APS-1 or isolated hypoparathyroidism, identifying novel AIRE gene mutations and expanding the spectrum of genetic abnormalities causing APS-1.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2022)
Article
Ophthalmology
Xing Wei, Tian Zhu, Lei Wang, Ruifang Sui
Summary: We reported a case of a Chinese patient with autoimmune polyglandular syndrome Type 1 (APS-1) who presented with Leber congenital amaurosis (LCA) as the initial and essential clinical feature. Through detailed medical and family history recording and comprehensive ophthalmological examinations, as well as whole exome sequencing (WES), a causative variant in the autoimmune regulator (AIRE) gene (NM_000383.3) was identified as the homozygous c.769C>T (p.R257X).
DOCUMENTA OPHTHALMOLOGICA
(2023)
Article
Biochemistry & Molecular Biology
Elena N. Savvateeva, Marina Yu. Yukina, Nurana F. Nuralieva, Marina A. Filippova, Dmitry A. Gryadunov, Ekaterina A. Troshina
Summary: The diagnosis of autoimmune polyglandular syndrome (APS) 1/2 is challenging due to their rarity and non-specific clinical manifestations. A new microarray-based multiplex assay was proposed for simultaneous detection of organ-specific and APS-1-specific autoantibodies. APS-1 patients were characterized by the presence of at least two specific autoantibodies. The accuracy of the multiplex assay compared to ELISA for organ-specific autoantibodies was high.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Genetics & Heredity
Jing Ruan, Xuan Wang, Xianyong Jiang, Miao Chen
Summary: This case report presents a female patient with APS1, PRCA, and LGLL, indicating a complex condition that responded well to glucocorticoid treatment. The casual relationship between AIRE and the development of LGLL and PRCA suggests potential immunological mechanisms.
BMC MEDICAL GENOMICS
(2021)
Article
Ophthalmology
Po-Ying Wu, Huai-Wen Chang, Wei-Li Chen
Summary: Patients with APS-1 may present ocular surface disease and severe corneal nerve damage. Regular follow-up and treatment with focus on corneal nerve regeneration are particularly important in these patients.
Review
Immunology
Roberto Perniola, Alessandra Fierabracci, Alberto Falorni
Summary: APS1, caused by pathogenic variants of the AIRE gene, is characterized by the classic triad of HPT, chronic mucocutaneous candidiasis, and AAD. In addition to endocrine manifestations, there may be early non-endocrine manifestations, with research focusing on the APS1-associated AAD.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Medicine, General & Internal
Camila M. Tautiva-Rojas, Roberto Bogarin-Solano, Carlos Santamaria-Quesada, Mariana Pacheco Munoz
Summary: Autoimmune polyglandular syndrome type I (APS1) is a rare disorder characterized by mucocutaneous candidiasis, hypoparathyroidism, and hypoadrenalism. It can also present with other symptoms such as dental problems, keratoconjunctivitis, fever, rash, chronic diarrhea, and autoimmune hepatitis. In this case, a 5-year-old female with a history of chronic mucocutaneous candidiasis and chronic diarrhea was diagnosed with primary hypoparathyroidism. Genetic testing confirmed the diagnosis of APS1 through the detection of a novel pathogenic homozygous AIRE mutation.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)
Article
Pediatrics
Marta Arrigoni, Paolo Cavarzere, Lara Nicolussi Principe, Rossella Gaudino, Franco Antoniazzi
Summary: We report a case of an 8-year-old girl with early-onset Addison's disease and autoimmune thyroiditis. This case highlights the importance of early detection of autoimmune polyglandular syndrome type 2 and appropriate treatment of adrenal insufficiency in a tertiary hospital. Additionally, we emphasize the importance of regular follow-up in patients with autoimmune diseases, as unrevealed and incomplete forms are common, especially in childhood.
ITALIAN JOURNAL OF PEDIATRICS
(2023)
Article
Immunology
Yael Goldfarb, Tal Givony, Noam Kadouri, Jan Dobes, Cristina Peligero-Cruz, Itay Zalayat, Golda Damari, Bareket Dassa, Shifra Ben-Dor, Yael Gruper, Bergithe E. Oftedal, Eirik Bratland, Martina M. Erichsen, Amund Berger, Ayelet Avin, Shir Nevo, Uku Haljasorg, Yael Kuperman, Adi Ulman, Rebecca Haffner-Krausz, Ziv Porat, Ulus Atasoy, Dena Leshkowitz, Eystein S. Husebye, Jakub Abramson
Summary: AIRE is crucial for central tolerance and preventing autoimmunity. Different AIRE mutations can cause autoimmunity in recessive or dominant-negative manners. Through various analyses, the mechanisms underlying these mutations have been uncovered, explaining why some are recessive while others are dominant.
JOURNAL OF EXPERIMENTAL MEDICINE
(2021)
Article
Medicine, General & Internal
Agyad Bakkour, Mohammed Deeb Zakkor, Lina Taha Khairy, Rostom Horo, Eman Mohammed Sharif Ahmed, Hachem Alhussein
Summary: This case report presents a rare case of a 9-year-old male with APS 2 and multiple gland insufficiencies. The report emphasizes the importance of early recognition and treatment of acute endocrine diseases, as well as the necessity to investigate pediatric patients with autoimmune diseases for coexisting conditions.
ANNALS OF MEDICINE AND SURGERY
(2022)
Article
Immunology
Andrea Arena, Antonio Stigliano, Eugenia Belcastro, Ezio Giorda, Maria Manuela Rosado, Armando Grossi, Maria Rita Assenza, Fabiola Moretti, Alessandra Fierabracci
Summary: This study investigates the potential impact of p53 reactivation by a peptide-based inhibitor on the immune response in thyroid carcinoma, specifically in relation to thyroid autoimmunity. Treatment with the inhibitor alters the percentages of regulatory and effector T cells, favoring an anti-cancer immune response without supporting autoimmune progression. The findings suggest a protective effect against autoimmune progression with reduced frequencies of activated T effector cells.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Biochemistry & Molecular Biology
Andrea Arena, Eugenia Belcastro, Antonella Accardo, Annamaria Sandomenico, Olivia Pagliarosi, Elisabetta Rosa, Stefania Petrini, Libenzio Adrian Conti, Ezio Giorda, Tiziana Corsetti, Riccardo Schiaffini, Giancarlo Morelli, Alessandra Fierabracci
Summary: Autoimmune endocrine disorders such as type 1 diabetes and thyroiditis currently rely on hormone replacement therapy, highlighting the need for personalized immunotherapeutic strategies targeting T and B lymphocytes. This study improved upon a personalized immunotherapeutic approach by functionalizing liposomes with Rituximab antibody, specifically targeting B lymphocytes in conditions like type 1 diabetes. The results showed that these functionalized liposomes had a significant inhibitory effect on the function of B lymphocytes, suggesting potential applicability for personalized immunotherapy in other autoimmune disorders where B lymphocytes are the primary pathogenic immune cells.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Editorial Material
Immunology
Alessandra Fierabracci, Domenico V. Delfino, Mary A. Markiewicz, Antonio La Cava
FRONTIERS IN IMMUNOLOGY
(2021)
Review
Pharmacology & Pharmacy
Isabella Muscari, Alessandra Fierabracci, Sabrina Adorisio, Marina Moretti, Lorenza Cannarile, Emira Ayroldi, Vu Thi Minh Hong, Domenico V. Delfino
Summary: Glucocorticoids exert their pharmacological actions by mimicking and amplifying the function of the endogenous glucocorticoid system's canonical physiological stress response. They affect the immune system at the levels of inflammation and adaptive and innate immunity. Interactions between glucocorticoids and natural killer cells are critical for successful glucocorticoid therapy.
BIOCHEMICAL PHARMACOLOGY
(2022)
Article
Immunology
Andrea Arena, Eugenia Belcastro, Francesca Ceccacci, Stefania Petrini, Libenzio Adrian Conti, Olivia Pagliarosi, Ezio Giorda, Simona Sennato, Riccardo Schiaffini, Peng Wang, James C. Paulson, Giovanna Mancini, Alessandra Fierabracci
Summary: The C1858T variant of the PTPN22 gene is associated with autoimmune diseases. Liposomes carrying siRNA targeting the C1858T variant have been functionalized with a high affinity ligand of Siglec-10, resulting in enhanced delivery to immunocytes expressing Siglec-10. This approach effectively downregulates the variant PTPN22 gene and restores IL-2 secretion in T1D patients.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Endocrinology & Metabolism
S. Cannavo, M. Cappa, D. Ferone, A. M. Isidori, S. Loche, M. Salerno, M. Maghnie
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
(2023)
Article
Medicine, General & Internal
Alessandra Fierabracci, Eugenia Belcastro, Elena Carbone, Olivia Pagliarosi, Alessia Palma, Lucia Pacillo, Carmela Giancotta, Paola Zangari, Andrea Finocchi, Caterina Cancrini, Domenico Vittorio Delfino, Marco Cappa, Corrado Betterle
Summary: Autoimmune diseases are a diverse group of immune system disorders that can be associated with immunodeficiency. This study examined the presence of AIRE gene variations in patients with high polyautoimmunity complexity and found a significant association between the S278R polymorphism of the AIRE gene and APECED-like conditions. Additional genetic determinants need to be identified to improve diagnosis and targeted therapies for these patients.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Biochemistry & Molecular Biology
Sara Petrillo, Jessica D'Amico, Francesco Nicita, Caterina Torda, Gessica Vasco, Enrico S. Bertini, Marco Cappa, Fiorella Piemonte
Summary: This study reveals the significant role of ferroptosis in the development and progression of X-linked adrenoleukodystrophy (X-ALD) and identifies a different antioxidant response between patients with AMN and cALD.
Article
Biochemistry & Molecular Biology
Stefano Levi Mortera, Valeria Marzano, Pamela Vernocchi, Maria Cristina Matteoli, Valerio Guarrasi, Simone Gardini, Federica Del Chierico, Novella Rapini, Annalisa Deodati, Alessandra Fierabracci, Stefano Cianfarani, Lorenza Putignani
Summary: Recent research has shown a correlation between the composition of the human gut microbiota and the onset of type 1 diabetes. In this study, a comprehensive metaproteomic investigation was conducted on children with type 1 diabetes, revealing potential gut microbiota features related to the severity of the disease.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Endocrinology & Metabolism
Anders Juul, Philippe Backeljauw, Marco Cappa, Alberto Pietropoli, Nicky Kelepouris, Agnes Linglart, Roland Pfaeffle, Mitchell Geffner
Summary: This study aimed to assess the impact of patient age at growth hormone (GH) therapy initiation on long-term growth outcomes and safety in short children born small for gestational age (SGA).
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Article
Endocrinology & Metabolism
Valeria Hasenmajer, Rosario Ferrigno, Marianna Minnetti, Bianca Pellegrini, Andrea M. Isidori, Andrea Lenzi, Mariacarolina Salerno, Marco Cappa, Li Chan, Maria Cristina De Martino, Martin O. Savage
Summary: Adrenal insufficiency is a severe endocrine disorder characterized by insufficient secretion of glucocorticoid and/or mineralocorticoid due to impaired adrenal function or inadequate adrenal stimulation. This review focuses on rare genetic causes of primary adrenal insufficiency with isolated glucocorticoid or combined glucocorticoid and mineralocorticoid deficiencies, as well as rare syndromes of isolated mineralocorticoid deficiency. The diagnosis of these rare genetic forms of pediatric adrenal insufficiency is challenging due to their clinical heterogeneity and rarity, and this review aims to provide an overview of their genetic and clinical features, as well as diagnostic and therapeutic approaches.
REVIEWS IN ENDOCRINE & METABOLIC DISORDERS
(2023)
Meeting Abstract
Endocrinology & Metabolism
Alessandra Fierabracci, Marco Cappa, Andrea Pietrobattista, Maria Felicia Faienza, Donatella Capalbo, Mariella Valenzise, Vito Lampasona, Olivia Pagliarosi, Elena Carbone, Maria Carolina Salerno, Corrado Betterle
HORMONE RESEARCH IN PAEDIATRICS
(2022)
Article
Biochemistry & Molecular Biology
Federica Del Chierico, Giorgia Conta, Maria Cristina Matteoli, Alessandra Fierabracci, Sofia Reddel, Gabriele Macari, Simone Gardini, Valerio Guarrasi, Stefano Levi Mortera, Valeria Marzano, Pamela Vernocchi, Fabio Sciubba, Federico Marini, Annalisa Deodati, Novella Rapini, Stefano Cianfarani, Alfredo Miccheli, Lorenza Putignani
Summary: Specific gut microbiota profiles were identified in T1D patients and their relatives, which differed from healthy subjects. These specific microbial and metabolic profiles may be associated with the progression and severity of T1D.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Pediatrics
Riccardo Schiaffini, Andrea Campana, Annalisa Deodati, Emanuela Peschiaroli, Maria Francesca Lanzillotta, Alessandra Fierabracci
Summary: This study reported a case of a child diagnosed with Type 1 diabetes during a paucisymptomatic COVID-19 infection, with well-controlled metabolic status throughout. The study speculated that SARS-CoV-2 infection may have acted as a precipitating factor in the disease, but the fundamental triggering event of the autoimmune disease may have occurred even before the infection.
ITALIAN JOURNAL OF PEDIATRICS
(2022)
Article
Medicine, General & Internal
Federico Baronio, Stefano Zucchini, Francesco Zulian, Mariacarolina Salerno, Rossella Parini, Alessandro Cattoni, Federica Deodato, Alberto Gaeta, Carla Bizzarri, Serena Gasperini, Andrea Pession
Summary: Diagnostic delay is common in MPS Ia due to the rarity of the disease and the variability of clinical presentation. A multidisciplinary panel developed an algorithm to improve awareness and reduce diagnostic delay of MPS Ia in pediatric endocrinologists.
MEDICINA-LITHUANIA
(2022)
Article
Genetics & Heredity
Xiangge Meng, Chengping Li, Yu Hei, Xiang Zhou, Guoli Zhou
Summary: The study used IVT-SAPAS sequencing to analyze the dynamic changes of APA sites during adipogenesis in bovine subcutaneous preadipocytes and intramuscular preadipocytes. The results showed that APA plays an important role in adipocyte differentiation, and UTR-APA switching genes have different trends, with intramuscular preadipocytes tending to use shorter 3'UTR for differentiation. TRIB3, WWTR1, and INSIG1 play important roles in intramuscular preadipocyte differentiation.
Article
Genetics & Heredity
S. Alizadeh, S. Khamse, N. Tajeddin, H. R. Khorram Khorshid, A. Delbari, M. Ohadi
Summary: This study identifies a specific genotype at a CG-rich trinucleotide short tandem repeat (STR) locus that is associated with late-onset neurocognitive disorders such as Alzheimer's disease (AD).
Article
Genetics & Heredity
Shougang Liu, Zhe Zhuang, Fanghua Liu, Xiuqing Yuan, Zeqiao Zhang, Xiaoqian Liang, Xinhui Li, Yongfeng Chen
Summary: This study investigated the effect and mechanism of RPL9 and TIFA in scalp psoriasis, and identified RPL9 as a potential therapeutic target for scalp psoriasis.
Article
Genetics & Heredity
Shiting Wang, Jiaqi Chen, Zhichao Jin, Ying Xing, Ruiping Wang
Summary: This study suggests a causal association between hair color and skin cancers, with light hair colors (red, blonde, and light brown) being associated with an increased risk and dark brown hair being associated with a decreased risk.
Article
Genetics & Heredity
Joseph Hawadak, Loick Pradel Kojom Foko, Rodrigue Roman Dongang Nana, Karmveer Yadav, Veena Pande, Aparup Das, Vineeta Singh
Summary: This study investigates the genetic diversity and natural selection of the Pfama-1 gene in Plasmodium falciparum isolates from Cameroon. The study finds a considerable nucleotide and haplotype diversity, as well as specific mutations in Cameroonian isolates. Positive diversifying selection and the identification of selected codon sites suggest the potential implication of these genetic variations in host immune pressure and parasite-binding complex modulation. The findings provide valuable baseline data for malaria vaccine design.
Article
Genetics & Heredity
Emily Biernat, Mansi Verma, Chhabi K. Govind
Summary: RSC is an essential ATP-dependent chromatin remodeling complex in Saccharomyces cerevisiae. It regulates nucleosome-depleted regions (NDRs) by sliding flanking nucleosomes away from NDRs. Depletion of RSC leads to nucleosome encroachment in NDRs and transcription initiation defects. The study compared the effects of catalytic-dead Sth1 and rapid depletion of Sth1 on transcription. Rapid depletion of Sth1 reduces recruitment of TBP and Pol II, while the catalytic-dead mutant exhibits a severe reduction in TBP binding but accumulates Pol II in coding regions. The results suggest a role for RSC in transcription elongation and termination processes.
Article
Genetics & Heredity
Yunxiao Wei, Yuhan Song, Muhammad Aamir Khan, Chengzhen Liang, Zhigang Meng, Yuan Wang, Sandui Guo, Rui Zhang
Summary: This study analyzed the GhTPP protein family in upland cotton for the first time and identified the important role of GhTPPA_2 in regulating sugar metabolism, improving soluble sugar accumulation, and drought stress tolerance.
Article
Genetics & Heredity
Yannan Geng, Rui Shao, Tiantong Xu, Lilong Zhang
Summary: A novel risk model based on SCUBE3, TNNC1, SPON1, SEPT12 and ULBP1 genes was developed for predicting PMOP risk, with higher risk score indicating higher risk of suffering from PMOP. Significant differences in signaling pathway activities were observed between the high-risk score group and the low-risk score group.
Article
Genetics & Heredity
Randy P. Williams, Corina Lesseur, Haoxiang Cheng, Qian Li, Maya Deyssenroth, Christopher D. Molteno, Ernesta M. Meintjes, Sandra W. Jacobson, Joseph L. Jacobson, Helen Wainwright, Ke Hao, Jia Chen, R. Colin Carter
Summary: The study suggests that heavy alcohol exposure during pregnancy may impact the proportion of fetal placental villi macrophages and increase the expression of inflammatory genes. Further research is needed to explore these effects and evaluate the potential functional roles of placental inflammation in FASD.
Article
Genetics & Heredity
Lvjing Luo, Lishuang Sun, Shu Li, Huiting Liu, Zhengyu Chen, Shi Huang, Yinyin Mo, Genliang Li
Summary: This study analyzed the expression of Ptpn1 and miR-124-3p in testicular tissues of mice and investigated their regulatory relationship. The results showed that Ptpn1 expression was up-regulated in adult mouse testis compared to juvenile mouse testis, while miR-124-3p expression showed an opposite pattern. Further analysis suggested that the down-regulation of miR-124-3p may contribute to the high expression of Ptpn1 in adult mouse testis.
Article
Genetics & Heredity
Gairui Li, Dan Zhao, Xiaolin Peng, Yashuang Zhao
Summary: MiRNA-22 shows potential as a candidate for early diagnosis of colorectal cancer (CRC). The study found higher miR-22 expression levels in the CRC and CRA groups, suggesting its potential as a biomarker for CRC early screening.
Article
Genetics & Heredity
Zhongqiu Zhu, Qianting Yang, Xiaoying Tian, Da Man, Jian Wang, Junfang Zhang, Bingshe Han
Summary: This study constructed a ceRNA network mediated by lncRNAs in cold-acclimated zebrafish ZF4 cells and revealed that upregulation of MSTRG3207 promotes apoptosis by sponging dre-miR-736 during cold acclimation.
Article
Genetics & Heredity
Weitao Chen, Denggao Xiang, Shang Gao, Shuli Zhu, Zhi Wu, Yuefei Li, Jie Li
Summary: Dam construction has negatively impacted the genetic diversity and structure of fish populations. This case study on the endangered Hemibagrus guttatus found low genetic diversity, high levels of inbreeding, and decreasing population size in fragmented populations. Genetic structure and differentiation were also observed, indicating the influence of dams on these fish populations.
Article
Genetics & Heredity
Pooja Singh, Debleena Guin, Bijay Pattnaik, Ritushree Kukreti
Summary: Through systematic literature review and meta-analysis, it was found that idiopathic pulmonary fibrosis is significantly associated with 222 polymorphisms in 118 genes. Four polymorphisms - rs35705950/MUC5B, rs2736100/TERT, rs2076295/DSP, and rs111521887/TOLLIP, exhibited substantial epidemiological evidence supporting their association with IPF risk.
Article
Genetics & Heredity
Jianping Zhang, Zhijun Cai, Fanzhe Feng, Yufeng Peng, Yi Cui, Yongiqing Xu
Summary: This study found that exosomes secreted by young BMSCs can promote the healing of tendon-bone interface after rotator cuff tears. These exosomes can improve extracellular matrix remodeling, osteogenic differentiation, angiogenesis, and stemness of tendon-derived stem cells (TDSCs). The exosomes from young BMSCs have better effects compared to those from aged BMSCs.