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The term refers to the collective network of leukocytes, including T cells, B cells, natural killer (NK) cells, and myeloid cells, that are coordinately regulated to maintain immunological homeostasis. In the context of regenerative medicine and immunotherapy, these populations are targeted by Mesenchymal Stem Cells (MSCs) to suppress pathological inflammation and promote immune tolerance (Galipeau & Sensébé, 2018). This modulation is achieved through a multi-modal mechanism involving the secretion of paracrine factors like indoleamine 2,3-dioxygenase (IDO) and prostaglandin E2 (PGE2), direct cell-to-cell contact via inhibitory ligands, and the release of exosomes containing bioactive microRNAs (Wang et al., 2021). Such systemic targeting is particularly relevant for complex conditions like Graft-versus-host disease (GvHD) and Crohn's disease, where single-target therapies often fail (Weiss & Dahlke, 2019). Therapeutic agents like Remestemcel-L interact with this 'target' by reprogramming the cytokine environment and inducing the expansion of regulatory T cells (Harrell et al., 2019). Monitoring the efficacy of these interventions typically requires broad profiling of systemic inflammatory markers and immune cell subsets.
Immunomodulation through the secretion of anti-inflammatory paracrine factors, direct inhibitory cell-surface interactions, and the transfer of regulatory molecules via exosomes.
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