Abstract:Objective To explore the effects of Achyranthes bidentata ethanol extract on knee osteoarthritis (KOA) based on m6A modifications mediated by synovial fluid exosomes.Methods Establish a KOA rat model using a modified Hulth method, and extract and identify synovial fluid exosomes. Use RT-PCR and other methods to detect changes in m6A modifications in KOA synovial fluid exosomes and identify differential m6A. Construct a synovial cell inflammation model, dividing the experiment into: control group, IL-1β group, IL-1β + si-NC group, and IL-1β + si-METTL3 group, to assess the impact of METTL3 on synovial cell viability and chemokine secretion. Evaluate the histological impact of METTL3 on KOA synovial degeneration using HE staining and Safranin O-Fast Green staining. Use Nanosight and RT-PCR to examine the effects of Achyranthes bidentata ethanol extract on the quantity, activity, and METTL3 expression in synovial fluid exosomes.Results After successful model establishment, micro-CT showed that the knee joint surface in the control group was smooth with normal joint spacing, whereas the model group exhibited a rough joint surface and narrowed joint space. Nanosight detection showed that exosome particles ranged from 76 to 80 nanometers. Western Blot analysis indicated high expression of CD9 and TSG101, and electron microscopy observed that the exosomes were elliptical with diameters less than 200 nanometers. m6A quantification kit detection revealed that the total m6A level was elevated in the KOA model, with METTL3 expression significantly higher than that in the control group (P < 0.05), while the expression of demethylases showed no significant change (P > 0.05). The impact of METTL3 silencing on synovial cell viability was examined. Compared to the IL-1β group and the IL-1β+si-NC group, the IL-1β + si-METTL3 group exhibited increased cell viability, with statistically significant differences (P < 0.05). The effect of METTL3 silencing on the secretion of synovial cell chemokines SDF-1 and MCP-1 was also assessed. Results indicated that the concentrations of SDF-1 and MCP-1 were reduced in the IL-1β + si-METTL3 group compared to the IL-1β group and the IL-1β + si-NC group, with statistically significant differences (P < 0.05). HE and Safranin O-Fast Green staining showed that the normal group had distinct cell layers with no significant inflammatory infiltration; the model group and the Scr-RNA group displayed disorganized cell arrangements along with vascular proliferation and inflammatory infiltration; the Sh-METTL3 group and the Achyranthes bidentata extract group showed reduced inflammatory infiltration and alleviated vascular proliferation. In cell experiments using serum containing Achyranthes bidentata extract, synovial cell viability was assessed. Compared to the model group, the Achyranthes bidentata extract group showed increased synovial cell viability, with statistically significant differences (P < 0.05). Compared to the METTL3 overexpression group, the METTL3 overexpression plus Achyranthes bidentata extract group also exhibited increased synovial cell viability, with statistically significant differences (P < 0.05). At the animal level, compared to the control group, the Achyranthes bidentata extract gavage group showed no significant change in exosome quantity and ACHE activity (P > 0.05), but METTL3 expression levels were reduced, showing statistically significant differences (P < 0.05).Conclusion High expression of METTL3 in KOA synovial fluid exosomes can reduce synovial cell viability and promote chemokine secretion. Achyranthes bidentata ethanol extract may alleviate KOA synovial degeneration by reducing METTL3 expression in exosomes.