Major approaches to melatonin and nutrients regulation in the bone regeneration process with exosomes and microRNAs: a systematic review

Introduction: Bone diseases comprise a large group of common diseases, including fractures, osteoporosis, and osteoarthritis that affect number individuals. Without intervention, the prevalence osteopenia is projected to increase 64.3 million Americans osteoporosis 11.9 by year 2030. Melatonin exerts numerous physiological effects, induction anti-inflammatory antioxidants, resetting circadian rhythms, promoting wound healing tissue regeneration, participating in maintenance regenerative processes bones cartilage. Objective: A systematic review was carried out present state art melatonin regulation, mesenchymal stem cells, exosomes, microRNAs, nutrients bone regeneration process. Methods: The rules (PRISMA) were followed. search from July September 2022 Scopus, PubMed, Science Direct, Scielo, Google Scholar databases, using scientific articles 2019 2022. quality studies based on GRADE instrument risk bias analyzed according Cochrane instrument. Results Conclusion: total 126 found. 59 fully evaluated 46 included this review. Considering tool for bias, overall assessment resulted 9 at high 24 did not meet GRADE. Most showed homogeneity their results, with I2 =97.8%>50%. symmetrical funnel plot does suggest between small sample-size studies. Based has important functions regulating activities cells modulate, together nutrients, exosomes microRNAs