MSC-exos modulated the AGEs-induced ER stress through activating the AKT and ERK signaling in human NP cells. The MSC-exos group was cotreated with AGEs (200 μg/mL) and MSC-exos (100 μg/mL). (A) The protein levels of AKT, p-AKT, ERK and p-ERK were assessed by western blotting. LY294002 (LY) is a broad-spectrum inhibitor of PI3K/AKT. PD98059 (PD) could inhibit the phosphorylation of ERK1/2 efficiently. (B-C) Western blot analysis and the quantitative statistical analysis showed the protein levels of p-AKT (B) and p-ERK (C). (D-G) The protein levels of CHOP (E), cleaved caspase-12 (F), cleaved-caspase-3 (G) were measured by western blotting and analyzed statistically. GAPDH was used as an internal control. Data were presented as the mean ± SD. *P < 0.05 vs. control group, #P < 0.05 vs. AGEs group, $P < 0.05. (H) Representative images of caspase-3, caspase-12 and CHOP protein expression were assessed by immunofluorescence staining. Magnification: 200 ×. (I-J) Representative images of TUNEL staining (I) and the quantitative statistical analysis (J) showed the rate of TUNEL-positive cells in different groups. Magnification: 200 ×. Data were presented as the mean ± SD. *P < 0.05 vs. control group, #P < 0.05 vs. AGEs group, $P < 0.05.