MiRNAs are small non-coding RNA molecules that play critical roles in the regulation of gene expression and have been closely associated with various diseases, including cancer. These molecules significantly influence the cell cycle of tumor cells and control programmed cell death (apoptosis). Currently, research on miRNAs has become a major focus in developing cancer therapies. Osteosarcoma, a malignant neoplasm predominantly occurring during adolescence and later in life, is characterized by a high propensity for metastasis. This review explores the role of miRNAs in the initiation and progression of cancer, highlighting their potential as predictive biomarkers for disease. It discusses the mechanisms by which natural products modulate miRNA activity to influence apoptosis, ferroptosis, and autophagy in osteosarcoma cells, aiming to identify new strategies for osteosarcoma treatment. Recent studies on how natural products regulate miRNAs to reduce tumor cell resistance to chemotherapy are also reviewed. Furthermore, the review elaborates on how natural products regulate m6A modifications to influence miRNA expression, thereby exerting antitumor effects. In this process, interactions between m6A modifications and miRNAs have been identified, with both jointly influencing tumorigenesis and cancer progression, offering a new perspective in osteosarcoma treatment. These approaches could help uncover novel regulatory mechanisms in osteosarcoma pathways and provide a theoretical foundation for developing new drugs and identifying novel therapeutic targets.

Background: This study aims to investigate the recent research hotspots and frontiers in the field of exosomes, offering a comprehensive review of advancements in exosome research and elucidating their implications and future directions. Methods: English-language exosome-related literature indexed in the Web of Science Core Collection database from January 1, 2015, to December 31, 2024, was retrieved, and the data were analyzed using CiteSpace and VOSviewer software. Results: A total of 26,458 articles were included. The annual publication volume showed steady growth before 2022, followed by fluctuations and stabilization after 2022. The most prolific author was Takahiro Ochiya; the institution with the highest output was Shanghai Jiao Tong University; China was the leading country in terms of publications and maintained extensive collaborations with other nations. Conclusion: Current exosome research primarily focuses on pharmacological effects, drug delivery, and diagnostic applications, attracting global scholarly attention and demonstrating promising development momentum.