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Structural damage progression evidenced by radiographs is very slow and does not always correlate with spinal mobility or QoL, and will rarely lead to alteration of treatment

Physiol Rev 99:9491045

Moreover, stem cell-derived exosomes are known to have anti-inflammatory, immunomodulatory, and antifibrotic capabilities, which have the potential to be used in the treatment of numerous inflammatory and chronic respiratory disorders [156, 157] Modulation strategies to overcome the barriers in the tumor microenvironment To a large extent, drug delivery using NPs is impeded by tumor heterogeneity, including atypical vasculature, stiff ECM, excessively generated glutathione (GSH), hypoxia, acidic pH, immune suppression, and their association with the TME [13, 158]