mRNA therapeutics for inflammatory bone diseases: opportunity and challenge.

Inflammatory bone diseases remain significant clinical challenges because of persistent inflammation and impaired bone remodeling. Conventional treatments, including non-steroidal anti-inflammatory drugs, biologics, and surgical procedures, primarily relieve symptoms but seldom restore osteoimmune homeostasis or regenerate damaged tissues. Recently, messenger RNA (mRNA) therapeutics have emerged as a transformative modality. They can encode virtually any protein, ranging from anti-inflammatory cytokines to osteogenic growth factors, thereby offering broad target applicability and design flexibility. Their small size facilitates cellular delivery, and its cytoplasmic action avoids the genomic integration risks associated with DNA-based approaches. Moreover, innovative formats including self-amplifying RNA, trans-amplifying RNA, and circular RNA extend expression duration and improve molecular stability. With ongoing breakthroughs in mRNA chemistry, delivery engineering, and novel combinatorial strategies, the clinical translation of mRNA therapeutics is expected to accelerate, offering a new era for the treatment of inflammatory bone diseases.