Advances in immunomodulatory strategies for meniscal regeneration_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Jiayi ^1,2 , LI Hao ^1,2 , MU Yuhao ^1,2 , HE Nan ^1,2 , GUO Zheng ^1,2 , LI Fakai ¹ , LIU Shuyun ^1,2 ,  GUO Quanyi ^1,2

1. Institute of Orthopedics, the Fourth Medical Center of the Chinese PLA General Hospital, Beijing Key Laboratory of Bio-Fabrication and Regenerative Translation Applications for Orthopedic Tissues and Organs, Key Laboratory of Musculoskeletal Trauma & War Injuries, Beijing, 100080, P. R. China;
2. School of Medicine, Nankai University, Tianjin, 300071, P. R. China;

Corresponding?author：

GUO Quanyi, Email: doctorguo_301@163.com

Keywords：

Meniscal regeneration; immune microenvironment; inflammation modulation; macrophage polarization; biomaterials; exosomes

DOI：

10.7507/1002-1892.202603023

Video：

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Objective To review the research progress regarding the effects of the local microenvironment after meniscal injury and immunomodulatory strategies for meniscal regeneration. Methods Relevant literature on meniscal regeneration, macrophage polarization, and tissue engineering was retrieved. The mechanisms underlying immune microenvironment imbalance after injury were summarized, and immunomodulatory interventions were analyzed from four perspectives: drugs and bioactive molecules, stem cells and exosomes, biomaterials, and external physical stimuli. Results The highly inflammatory microenvironment dominated by M1 macrophages after injury significantly hinders tissue repair. Current studies mainly promote functional meniscal regeneration through immunomodulatory interventions in four aspects: drugs and bioactive molecules inhibit inflammatory cascades by blocking inflammatory receptors and related signaling pathways; stem cells and exosomes modulate the local immune microenvironment through paracrine effects and enhance the functions of repair-related cells; functionalized biomaterials achieve synergy between immunomodulation and mechanical support through active component delivery, physicochemical property regulation, and structural design; and external physical stimuli, such as acoustic, electrical, and magnetic stimulation, serve as non-invasive auxiliary approaches for inflammation regulation and tissue repair. Conclusion Remodeling the immune microenvironment is critical for functional meniscal regeneration. Smart scaffolds with both mechanical support and immunomodulatory functions should be further developed.

Citation： LI Jiayi, LI Hao, MU Yuhao, HE Nan, GUO Zheng, LI Fakai, LIU Shuyun, GUO Quanyi. Advances in immunomodulatory strategies for meniscal regeneration. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(8): 1286-1296. doi: 10.7507/1002-1892.202603023 Copy

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Chinese Journal of Reparative and Reconstructive Surgery

Advances in immunomodulatory strategies for meniscal regeneration

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