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Mesenchymal stem cell (MSC) paracrine signaling refers to the process by which MSCs influence their environment and other cells through the secretion of soluble factors, extracellular vesicles (EVs), and exosomes. This secretory activity is a principal mechanism underlying many of the therapeutic effects attributed to MSC-based therapies. Key components include cytokines, chemokines, growth factors (e.g., VEGF, bFGF, HGF, IGF-1), prostaglandins (e.g., PGE2), IDO, and EVs containing miRNAs. The signaling is involved in immunomodulation, angiogenesis, anti-apoptosis, and antifibrosis. Clinical relevance spans regenerative medicine applications for osteoarthritis, myocardial infarction, and other disorders. Therapeutic use may involve transplantation of live MSCs or administration of isolated secretome/EV products. Engineering approaches aim to enhance the secretome potency for targeted therapies.
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