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Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) are nano-sized, membrane-bound particles secreted by mesenchymal stem cells that mediate paracrine signaling and tissue homeostasis (Kalluri & LeBleu, 2020). They contain a complex cargo of proteins, lipids, and nucleic acids, including regulatory mRNA and miRNA, which are delivered to recipient cells to modulate gene expression and signaling pathways (Théry et al., 2018). MSC-EVs are recognized for their potent immunomodulatory properties, such as inhibiting the activation of T cells and promoting the polarization of anti-inflammatory M2 macrophages (Harrell et al., 2019). Additionally, they facilitate tissue regeneration by stimulating angiogenesis, enhancing cell proliferation, and reducing oxidative stress and apoptosis in damaged tissues (Gatti et al., 2011). As a cell-free therapeutic modality, MSC-EVs offer advantages over whole-cell therapies, including lower immunogenicity, easier storage, and the ability to cross the blood-brain barrier (Tsiapalis & O'Driscoll, 2020). They are currently being investigated for a wide range of clinical applications, including cardiovascular, respiratory, and autoimmune diseases.
MSC-EVs function through the horizontal transfer of bioactive cargo, including microRNAs (e.g., miR-21, miR-146a) and proteins (e.g., TGF-β, IL-10), which reprogram recipient cells to suppress pro-inflammatory signaling (e.g., NF-κB) and activate regenerative pathways (e.g., Wnt/β-catenin).
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