The secretion profile of mesenchymal stem cells and potential applications in treating human diseases

Single-cell Raman spectroscopy as a novel platform for unveiling the heterogeneity of mesenchymal stem cells

Despite the significant potential of mesenchymal stem cells (MSC) therapy in clinical settings, challenges persist regarding the efficient detection of consistency and uniformity of MSC populations. Raman spectroscopy is a fast, convenient, and nondestructive technique to acquire molecular properties of biomolecules across laboratory and mass-production settings. Here we utilized Raman spectroscopy to evaluate the heterogeneity of primary MSC from varying donors, passages, and distinct culture conditions, and compared its effectiveness with conventional techniques such as flow cytometry. Although these MSC exhibited insignificant differences in morphology and surface markers in flow cytometry analysis, they could be distinctly clustered into different populations by Raman spectroscopy and the subsequent machine learning using linear discriminant analysis. Principal component analysis demonstrated limited efficiency in clustering Raman data from diverse sources, which could be enhanced through combination with support vector machine or deterministic finite automation. These findings highlight the sensitivity of Raman spectroscopy in detecting subtle differences. Moreover, the analysis of characteristic Raman peaks attributed to cellular biomolecules in MSC from passages 2 (P2) to P10 revealed a gradual decrease in the levels of nucleic acids, lipids, and proteins with increasing passages, and a significant increase in carotenoids from P8. These results suggest the potential use of Raman spectroscopy to assess cellular biochemical characteristics such as aging, with carotenoids emerging as a potential marker of cell aging. In conclusion, Raman spectroscopy demonstrates the ability to rapidly and non-invasively detect cellular heterogeneity and biochemical status, offering significant potential for quality control in stem cell therapy.

Advances in Cell-based therapies for peripheral arterial disease

PURPOSE

To examine recent advances in cell-based therapies for peripheral arterial disease (PAD), focusing on mechanisms of action, clinical applications, and regulatory considerations. The review aimed to evaluate the therapeutic potential of various cell types and assess their efficacy in addressing the unmet needs of PAD patients,particularly those with critical limb ischemia (CLI).

METHODS

The review analysed current literature on cell-based therapies for PAD, including preclinical studies using animal models, clinical trials from phase I to III, and regulatory frameworks. Multiple cell types were evaluated, including mesenchymal stem cells (MSCs), endothelial progenitor cells (EPCs), bone marrow mononuclear cells (BMMNCs),and adipose-derived stem cells (ADSCs).

RESULTS

Preclinical studies demonstrated significant improvements in limb perfusion and neovascularization across various cell types. Clinical trials, particularly those utilizing MSCs and BM-MNCs, showed encouraging outcomes in wound healing and reduced amputation rates. The therapeutic effects were mediated through multiple mechanisms, including direct vessel formation, paracrine signalling, immunomodulation, and tissue repair. The FDA's implementation of a tiered, risk-based system for human cells, tissues, and cellular and tissue-based products (HCT/Ps) has provided a regulatory framework balancing innovation with safety.

CONCLUSION

Cell-based therapies show promising potential for PAD treatment, particularly for patients with limited conventional treatment options. While clinical trials demonstrate encouraging results, challenges remain in standardizing cell characterization methods and establishing appropriate potency assays. Future research should focus on optimizing cell delivery methods, identifying the most effective cell types, and conducting larger clinical trials to establish definitive efficacy.

Scientometric analysis of evolution in sex-specific MSC therapy for cardiovascular diseases

BACKGROUND

Mesenchymal stem cell (MSC) therapy for cardiovascular diseases has shown promise; however, sex-specific differences remain understudied. This scientometric analysis provides the first comprehensive overview of sex-specific differences in mesenchymal stem cell (MSC) therapy for cardiovascular diseases, spanning from 1947 to 2024.

METHODS

We analyzed 61,029 publications using advanced bibliometric tools to identify research hotspots, publication trends, and collaborative networks.

RESULTS

A significant shift in research focus has been observed in the field of mesenchymal stem cell (MSC) therapy for cardiovascular diseases, transitioning from broad cardiovascular concepts in the 20th century to specialized sex-specific considerations in the 21st century. Furthermore, in the 21st-century research landscape, the formation of two distinct clusters for "male" and "female" in VOSviewer-generated network visualizations is highly important, emphasizing the growing recognition of sex-specific differences in MSC therapy responses and outcomes. This shift was accompanied by a marked increase in terminology related to sex-specific differences, with keywords like "genetic association" and "body mass index" forming distinct clusters in recent years.

CONCLUSIONS

This analysis underscores the critical need for sex-specific considerations in MSC therapy for cardiovascular disease. The emergence of distinct male and female clusters in research networks emphasizes the importance of tailoring approaches based on sex differences. Key areas identified for future investigation include the role of epigenetics in mediating sex-specific effects and the potential of sex-matched MSC-derived exosomes. These findings pave the way for more effective and personalized approaches in cardiovascular regenerative medicine, potentially leading to improved outcomes through sex-specific therapeutic strategies.

Exploring the association between aging, ferroptosis, and common age-related diseases

Aging is a natural biological process that is characterized by the progressive decline in physiological functions and an increased vulnerability to age-related diseases. The aging process is driven by different cell and molecular mechanisms. It has recently been shown that aging is associated with heightened vulnerability to ferroptosis (an intracellular iron-dependent form of programmed cell death). This susceptibility arises from various factors including oxidative stress, impaired antioxidant defences, and dysregulated iron homeostasis. The progressive decline in cellular antioxidant capacity and the accumulation of damaged components contribute to the increased susceptibility of aging cells to ferroptosis. Dysregulation of key regulators involved in ferroptosis, such as glutathione peroxidase 4 (GPX4), iron regulatory proteins, and lipid metabolism enzymes, further exacerbates this vulnerability. The decline in cellular defence mechanisms against ferroptosis during aging contributes to the accumulation of damaged cells and tissues, ultimately resulting in the manifestation of age-related diseases. Understanding the intricate relevance between aging and ferroptosis holds significant potential for developing strategies to counteract the detrimental effects of aging and age-related diseases. This will subsequently act to mitigate the negative consequences of aging and improving overall health in the elderly population. This review aims to clarify the relationship between aging and ferroptosis, and explores the underlying mechanisms and implications for age-related disorders, including neurodegenerative, cardiovascular, and neoplastic diseases. We also discuss the accumulating evidence suggesting that the imbalance of redox homeostasis and perturbations in iron metabolism contribute to the age-associated vulnerability to ferroptosis.

Effects of Wharton's jelly mesenchymal stromal/stem cells-derived conditioned medium and platelet-rich plasma on in vitro induced equine endometrial inflammation

Over the years, regenerative therapies have emerged as promising alternatives for persistent breeding-induced endometritis. In vitro studies testing the effects of these therapies on equine endometrial cells are still scarce. This study aimed to evaluate in vitro the effect of Wharton's jelly (WJ) mesenchymal stromal/stem cell (MSCs)-derived conditioned medium (WJ-CM) and platelet-rich plasma (PRP) on equine endometrial cells, with or without lipopolysaccharide (LPS)-induced inflammation. The WJ-CM was obtained after 24 h of starvation in Ringer's lactate of WJ-MSCs and PRP was prepared using the double centrifugation. Endometrial epithelial cells obtained from 3 diestrus mare uteri at slaughterhouse were treated for 24 h according to six experimental groups: DMEM standard complete medium (CTRL); 10 ng/mL LPS (LPS); 10 % WJ-CM (CM); 5 % PRP (PRP); 10 ng/mL LPS and 10 % WJ-CM (LPS + CM); 10 ng/mL LPS and 5 % PRP (LPS + PRP). After 6, 12, and 24 h, endometrial cells were evaluated for viability (apoptosis and necrosis), mitochondrial activity and reactive oxygen species (ROS) generation. PGE-2 and IL-10 concentrations in spent medium were measured. The WJ-CM alone did not affect endometrial cell viability and prevented the detrimental effect of LPS on endometrial cells; it suppressed the production of PGE-2. PRP had a deleterious effect on endometrial cell viability, induced the secretion of PGE-2, as well as increased mitochondrial activity and ROS production. Endometrial benefits of the WJ-CM treatment are evident even after an LPS challenge, while unexpectedly PRP showed a deleterious effect.

Exosomes derived from human umbilical cord mesenchymal stem cells can reverse ventricular remodeling and improve long-term cardiac function after acute myocardial infarction

BACKGROUND

Acute myocardial infarction (AMI) is the most common ischemic heart disease with high morbidity and high mortality. Although the treatment of AMI is constantly developing, ischemia-reperfusion (I/R) injury remains a complex problem. In recent years, human umbilical cord-derived mesenchymal stem cell-derived exosomes (hUC-MSC-EXO) have been shown to alleviate related damages. However, the long-term effects, safety, and mechanism of action have not yet been fully explored.

METHODS

We constructed human umbilical cord-derived mesenchymal stem cell-derived engineered exosomes. We compared the short-term and long-term protective abilities of engineered exosomes on myocardium during I/R in cardiomyocytes and rat models, and determined their long-term safety. At the same time, key pathways and genes were predicted through exosome sequencing.

RESULTS

hUC-MSC-EXO significantly reduced apoptosis, oxidative stress, and inflammation in both in vitro and in vivo models. In I/R rats, IMTP-EXO demonstrated superior cardioprotective effects, reducing myocardial fibrosis and improving left ventricular function compared to controls. Long-term studies showed enhanced ejection fraction (EF) and fractional shortening (FS) and reduced left ventricular end-diastolic dimensions (LVEDD). Fluorescence imaging revealed higher exosome accumulation in ischemic hearts. Genes related to cardiovascular diseases were obtained through cross-comparison of multiple databases. GO analysis revealed that protein binding was the most highly enriched term. KEGG analysis showed that these genes were primarily involved in apoptosis and the PI3K-Akt signaling pathways. The PPI network showed that TP53, TLR4, EGFR, MAPK3, and GJA1 are central genes of heart I/R injury. GJA1, HMGB1, and PTEN are considered to be key genes by comparing to the comparative toxicogenomic database (CTD).

CONCLUSIONS

This study demonstrates that hUC-MSC-derived exosomes, especially IMTP-EXO, are safe, feasible, and effective for reversing ventricular remodeling and improving cardiac function in rat MI models. GJA1, HMGB1, and PTEN may be the key genes associated with myocardial I/R injury. These findings provide critical insights for translating hUC-MSC-EXO into clinical applications for treating myocardial I/R injuries.

Exosomal miRNA combined with anti-inflammatory hyaluronic acid-based 3D bioprinted hepatic patch promotes metabolic reprogramming in NAFLD-mediated fibrosis

Non-alcoholic fatty liver disease (NAFLD) is a complex metabolic disorder, where the underlying molecular mechanisms are mostly not well-understood and therefore, warrants the need for therapeutic interventions targeting several metabolic pathways as a unified response. Of late, promising outcomes have been observed with mesenchymal stem cell-derived exosomes. However, reduced bioavailability due to systemic delivery and the need for repeated fresh isolation hinders their feasibility for clinical applications. In this regard, an 'off-the-shelf' 3D bioprinted hyaluronic acid-based hepatic patch to deliver encapsulated exosomes alone/or with hepatocytes (as dual-therapy) is developed as a holistic approach for ameliorating the disease condition and promoting tissue regeneration. The bioprinted hepatic patch demonstrated sustained and localized release of exosomes (∼82 % in 21 days), and healthy liver tissue-like mechanical properties while being biocompatible and biodegradable. Assessment in NAFLD rat models displayed alleviation of the altered biochemical parameters such as fat deposition, deranged liver functions, disrupted lipid, glucose, and insulin metabolism along with a reduction in localized inflammation, and associated liver fibrosis. The study suggests that a synergistic effect between the miRNA population of released exosomes, cell therapy, and the bioprinted matrix materials is crucial in targeting multiple complex metabolic pathways associated with the severity of the disease.

Microenvironment-Dependent MSC Immunoregulation in Type 1 Diabetes: Insights From IFNγ Preconditioning

Interferon-gamma (IFNγ) plays a crucial role in the pathogenesis of type 1 diabetes (T1D) and is widely utilized to license mesenchymal stem/stromal cells (MSCs) to enhance their immunosuppressive properties through a process known as preconditioning or priming. This study investigates the interaction of MSCs preconditioned with (IFNγ+) or without (IFNγ-) IFNγ, with peripheral blood mononuclear cells (PBMCs) from healthy controls (HC) and T1D patients. We assessed the effects of these interactions on anti-inflammatory gene expression, chemokine and receptor profiles, and the induction of regulatory T (Treg) cells. Our findings reveal contrasting responses in HC and T1D PBMCs when exposed to IFNγ+ and IFNγ- MSCs, particularly in the expression of key genes such as CXCR3 and its ligands (CXCL9, CXCL10), CXCR6, CCR5, and its ligands (CCL3 and CCL4). Pathway enrichment analysis further showed that IFNγ preconditioning tailors MSC responses to specific immune microenvironments. These differential gene expression patterns were also reflected in the proportions of Treg cells, which varied depending on whether paracrine signaling or direct cell contact was involved. Collectively, our results demonstrate that IFNγ+ and IFNγ- MSCs create distinct immunomodulatory microenvironments in T1D PBMCs compared to HC PBMCs, emphasizing the potential for tailored MSC-based therapies in T1D treatment.

Uncovering the bequeathing potential of apoptotic mesenchymal stem cells via small extracellular vesicles for its enhanced immunomodulatory and regenerative ability

BACKGROUND

Mesenchymal Stem Cells-derived Small Extracellular Vesicles endowed with regenerative cargo from their parent cells, have emerged as a promising avenue for cell-free therapeutics in regenerative medicine. Notably, deliberate induction of apoptosis in MSCs before sEV isolation has been identified as a strategy to augment the regenerative capabilities of MSCs-sEVs. This study explores a novel approach to enhance the immunomodulatory potential of MSC-sEVs through apoptosis induction and optimal tissue source to ensure consistent and improved clinical outcomes.

METHODS

Apoptosis was induced in tissue-specific MSCs using Staurosporine. sEVsV and sEVsApo were isolated via ultracentrifugation. Invitro immune response was assessed via T-cell proliferation, T-regulatory cell induction & macrophage polarization assay. Mitochondrial bioenergetics was studied using MitoSOX staining and Seahorse assay in H2O2-treated HuH7 cells. These findings were validated invivo in the CCL4-induced Chronic Liver Disease model via Histopathological staining, biochemical parameters, and fibrotic, pro-inflammatory, and anti-inflammatory markers and assessed the mechanism by targeting TGF-β/SMAD pathway.

RESULTS

Our results demonstrate that sEVsApo exhibited significantly higher concentrations and superior immunomodulatory effects by suppressing CD3 + T-cell proliferation, promoting T-regulatory cell differentiation, and polarized macrophages towards M2-phenotype. In terms of tissue specificity, it was observed that WJ-sEVs were faring better. sEVsApo effectively reduced mitochondrial ROS & significantly improved oxidative phosphorylation. Invitro findings were corroborated in an invivo CLD model, wherein sEVsApo ameliorated fibrosis and inflammation, by inhibiting TGF-β/ SMAD2/3 pathway.

CONCLUSION

This study concludes that apoptosis induction can be considered as minimum manipulation strategy to enhance the immunoregulatory and regenerative potential of MSCs-sEVs, thereby expanding their implication in immune disorder.

Secretome Derived From Mesenchymal Stem Cells Cultured as Monolayer Show Enhanced Bone Regeneration Compared to Secretome From 3D Spheroid - Clues From the Proteome

Repair and reconstruction of critical-sized bone defects present a significant challenge due to poor clinical outcomes of conventional bone repair strategies, such as autologous and allogenic bone grafts. The present study underscores the potential of human dental pulp stem cell-derived trophic factors to promote bone repair and regeneration, thus evading the risks associated with cell-based therapy. This study utilizes pre-osteoblast cells to evaluate the osteogenic potential of 2 Dimensional (2D) and 3 Dimensional (3D) secretome from monolayer and spheroid cultures of dental pulp stem cells (DPSCs), respectively. In-vitro results on pre-osteoblast cells (MC3T3-EI) treated with 2D and 3D secretome reveal lower mineralization and mRNA expression of osteogenic specific genes in 3D secretome in comparison to 2D secretome. Furthermore, 2D secretome shows better bone regeneration ability in rat models of calvarial bone defect compared to the 3D secretome. The proteomic profiles of 2D and 3D secretomes are also in concordance with these results and reveal key molecules governing bone regeneration potential. This data highlights the influence of culture conditions on the secretory pattern of mesenchymal stem cells and provides valuable insights for the development of a more effective secretome-based cell-free alternative for novel bone repair and regeneration.

Activation of eIF2α-ATF4 by endoplasmic reticulum-mitochondria coupling stress enhances COX2 expression and MSC-based therapeutic efficacy for rheumatoid arthritis

BACKGROUND

Mesenchymal stem/stromal cell (MSC) therapy holds promise as a therapeutic strategy for rheumatoid arthritis (RA). However, the loss of secretory function following cell delivery has significantly restricted its clinical application. Our preliminary studies confirmed that endoplasmic reticulum stress (ERS)-MSCs greatly inhibited RA follicular helper T cells (Tfh) through cyclooxygenase-2 (COX2)/prostaglandin E2 (PGE2) pathway activation via an unknown molecular mechanism, demonstrating the therapeutic effects of ERS-modified MSCs on RA.

METHODS

To compare their therapeutic efficacy, thapsigargin (TG)-stimulated or unstimulated MSCs were transplanted into collagen-induced arthritis (CIA) mice. Joint inflammation was evaluated from both general and histological aspects. Splenocytes were isolated, and flow cytometry was performed to assess the proportions of T helper 1 (Th1), Th17, and Tfh subsets. Additionally, the levels of TNF-α in mouse serum were measured using ELISA. For mechanistic exploration, the TRRUST and Cistrome Data Browser databases were used to analyse transcription factors related to COX2 regulation, as well as target genes regulated by activating transcription factor 4 (ATF4). To identify the most effective treatment concentration and duration for inducing ERS, we conducted a concentration and time gradient analysis for TG treatment via qRT‒PCR and a CCK‒8 assay. Then, western blotting and qRT‒PCR were employed to determine the level of ATF4 in ERS-MSCs. To verify the function of ATF4 in vivo, ATF4-overexpressing MSCs were transplanted into CIA mice, the levels of joint inflammation as well as the proportions of Th1, Th17 and Tfh subsets were analysed. To clarify the molecular regulatory mechanism leading to ATF4 activation, the protein levels of protein kinase RNAs, such as endoplasmic reticulum kinase (PERK)/phosphorylated-PERK (p-PERK) and eukaryotic initiation factor 2α (eIF2α)/phosphorylated-eIF2α (p-eIF2α) were examined. Furthermore, the levels of ATF4 and eIF2α/p-eIF2α were assessed after PERK blockade. Mitochondrial stress was subsequently examined in ERS-MSCs. Finally, when blocking ERS and mitochondrial stress were inhibited separately or simultaneously, the levels of ATF4 and eIF2α/p-eIF2α were reevaluated.

RESULTS

Compared with MSCs, ERS-MSCs exhibited greater therapeutic efficacy in CIA mice. Public databases and bioinformatics analyses confirmed the regulatory role of ATF4 in COX2, and experimental methods further demonstrated that ATF4-transfected MSCs alleviated joint inflammation in CIA mice. We also demonstrated that during ERS induction, PERK-mediated eIF2α phosphorylation contributes to the activation of ATF4. Furthermore, mitochondrial stress was also provoked in ERS-MSCs, and ERS synergistically regulated ATF4.

CONCLUSIONS

Compared with unmodified MSCs, ERS-MSCs exhibited enhanced immunosuppressive potency, primarily through COX2 overexpression, which was regulated by ATF4 activation. Moreover, ERS and mitochondrial stress jointly regulated ATF4 expression. This study reveals a novel role of ATF4 in enhancing the secretory properties of MSCs and has thereby presents a promising MSC-based therapeutic strategy for the treatment of RA.

Adipose derived stem cell activation by macrophages and tendon fibroblasts

AIMS

Tendon injuries are common, and healing often fails due to an over-exuberant inflammatory response and a lack of regeneration. Inflammatory cells play key roles in these processes, with a balance between classically activated pro-inflammatory M1 macrophages and alternatively activated inflammatory resolving M2 macrophages. Adipose-derived mesenchymal stem cells (ASCs) can dampen the pro-inflammatory effectsof macrophages, promote a regenerative environment, and enhance healing. Therefore, the goal of the study was to understand how ASCs are activated by macrophages in vitro.

METHODS

In vitro co-culture experiments were carried out with ASCs, macrophages, and tendon fibroblasts. RNA-seq and qRT-PCR were performed to determine expression patterns of activated ASCs.

RESULTS

M1 macrophages prompted ASCs to upregulate pro-inflammatory signaling, matrix remodeling, and cytokine production pathways, while downregulating those related to cell adhesion and cell cycle. Conversely, TFs prompted ASCs to upregulate pathways involved in cell cycle and cytoskeleton remodeling, and to downregulate pathways associated with immune cell adhesion, inflammatory mediator production, and protein metabolism.

CONCLUSIONS

The cell-specific activation profiles indicate a possible switch in ASC paracrine signaling depending on the context, from a pro-inflammatory pattern in response to M1 macrophages to a proliferative pattern in response to TFs. Understanding crosstalk between ASCs, TFs, and macrophages is essential for developing stem cell-based therapeutic strategies.

Umbilical Cord-Derived Mesenchymal Stem Cells Infusion in Type 2 Diabetes Mellitus Patients: A Retrospective Cytopeutics' Registry Study

Background

Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, leading to elevated blood glucose levels. Cellular therapies offer promise for improving hyperglycemia in T2DM. This retrospective study aimed to assess the clinical effectiveness of intravenous allogeneic umbilical cord-derived mesenchymal stem cells (UC-MSCs) infusion in T2DM patients through various clinical evaluations, focusing on systemic inflammation, metabolic dysfunction, and insulin resistance.

Methods

The data from a total of 218 T2DM patients who attended for follow-up after 6 months, and 83 patients after 12 months after receiving 50-100×10⁶ allogeneic UC-MSCs were analyzed. Blood and urine samples were collected at baseline and follow-up. Key evaluations included changes in anthropometry, diabetes indices, lipids, liver, renal, hormonal, and inflammatory markers.

Results

All patients demonstrated satisfactory outcomes, without adverse effects. Significant reductions in HbA1c levels were observed at 6-months (p<0.001) and 12-months (p=0.016). Insulin (p=0.048) and HOMA-IR (p=0.007) levels significantly reduced within 6-months, with same trend at 12-months. ALT and GGT levels significantly decreased (p<0.05), indicating a reduction in liver inflammation. hs-CRP level among patients with higher inflammation were also reduced at 6-months (p=0.073) and significantly at 12-months (p=0.016). Testosterone (p=0.050) and estradiol (p=0.043) levels increased in males and females, respectively, during 12-month follow-up. Additionally, estimated glomerular filtration rate (eGFR) and creatinine levels improved in stage 2 chronic kidney disease (CKD) at 6- and 12-month (p<0.05), indicating recovered renal function for those in early stage of CKD.

Conclusion

Allogeneic UC-MSCs infusion is safe for patients with T2DM and is associated with overall health outcomes, with sustained benefits up to 12 months. Notably, the treatment significantly improved metabolic indices including glycemic control, liver and renal profile and systemic subclinical inflammation. These findings provide a basis for further exploration of UC-MSCs in managing T2DM in proper randomized control trial, by addressing both metabolic dysregulation and inflammation.

An evaluation of spraying as a delivery method for human mesenchymal stem cells suspended in low-methyl pectin solutions

BACKGROUND

Mesenchymal stem cells have shown promise in many areas of regenerative medicine due to the anti-inflammatory and pro-regenerative effects of the secreted factors. However, successful delivery remains problematic, particularly for delivery to areas such as the brain. Spray delivery is a method investigated in wound care and lung injury, which may be applicable for brain delivery to patients already requiring surgery. To retain therapeutic mesenchymal stem cells at the delivery site, biomaterials can be employed; pectin is a biocompatible, sprayable, and mucoadhesive material, which could prove suitable for spray delivery of cells for therapeutic uses.

METHODS

The biocompatibility of four grades of low-methyl pectin gelled by addition of calcium was assessed using SH-SY5Y cells. After, mesenchymal stem cells were suspended within the four different grades of low-methyl pectin solutions and sprayed using a syringe-driven spray device. The suitability was then assessed by cell viability testing, flow cytometry to test for surface markers, and differential gene expression studies to understand the effects of both the pectin and the spraying process on the gene expression of the cells.

RESULTS

All four grades of low-methyl pectin were biocompatible with SH-SY5Y cells. The syringe-driven spray device delivered human mesenchymal stem cells to well plates with high viability, and suspending these cells in pectin solutions for spraying did not negatively affect the viability. The grade of pectin named CU-701 was the best grade based on results of the flow cytometry, whereby the surface marker expression was not altered from the control cells. The RNA sequencing showing the differential expression showed that the process of spraying the cells did not alter gene expression compared to the control, however the pectin, and the presence of calcium used to induce gelation of the pectin, did lead to altered gene expression in cells.

CONCLUSION

Spraying is a suitable delivery method for the mesenchymal stem cells, showing no detrimental effect on the cells. Pectin shows little effect on the viability of the cells, however the use of calcium to gel the pectin appears to affect the expression of several genes.

Preconditioning of bone marrow mesenchymal stem cells with sodium hydrosulfide enhances their therapeutic potential in type II collagen-induced arthritis rat model

This study was conducted to evaluate the impact of sodium hydrogen sulfide (NaHS) on the therapeutic efficacy of bone marrow mesenchymal stem cells (BM-MSCs) in the treatment of collagen-induced arthritis (CIA) rats. MSCs were isolated and cultured from rat bone marrow, and their characteristics were determined. The CIA model was induced in rats by intradermal injections of type II collagen on days 0 and 21. A variety of treatments were administered, including naproxen, BM-MSCs, BM-MSC-conditioned media, NaHS, BM-MSCs preconditioned with NaHS, and BM-MSCs preconditioned with NaHS-conditioned media. The infused BM-MSCs homed to the bone trabeculae and cartilage of the knee joint, leading to significant improvements in gait scores and a reduction in paw withdrawal frequency (PWF). Treatment with BM-MSCs and NaHS also significantly suppressed serum levels of CRP, RF, and 14-3-3η, while downregulating TNF-α gene expression and MMP-1 protein levels in the synovial membrane. Histopathological analysis confirmed these biochemical and molecular genetic findings. Notably, CIA rats treated with BM-MSCs preconditioned with NaHS showed the most significant improvements, with outcomes closely resembling those of healthy controls. This study concludes that NaHS enhances the therapeutic efficacy of BM-MSC therapy for rheumatoid arthritis (RA) by augmenting their anti-inflammatory, immunomodulatory, and regenerative properties.

Immunomodulatory interactions between mesenchymal stromal/stem cells and immune cells in psoriasis: therapeutic potential and challenges

Psoriasis is defined as a persistent autoimmune disease characterized by the appearance of psoriatic lesions on the surface of the skin. Currently, various approaches including chemicals, corticosteroids, phototherapy, and biological agents are being proposed and implemented to improve psoriatic lesions by modulating immune system activity or metabolic processes, often with unintended consequences and side effects. Currently, mesenchymal stromal/stem cells (MSCs) have attracted considerable interest among researchers due to their ability to modulate immune responses and their ease of application, representing a promising strategy for alleviating clinical symptoms in the treatment of allergic reactions, autoimmune diseases, cancer, and more. This study will investigate how MSCs interact with immune system cells involved in psoriasis development, such as neutrophils, keratinocytes, dendritic cells (DC), and T cell subtypes, for potential therapeutic use in psoriasis management. In this case, several immunomodulatory mechanisms are involved, including expression of chemokines, pro-inflammatory cytokines, matrix metalloproteinase and other factors involved in cell proliferation and neutrophil extracellular trap (NET) formation are among the effects of MSCs on keratinocytes and neutrophils. keratinocytes and neutrophils as pro-inflammatory cells involved in psoriasis pathogenesis and pathogenesis and progression of psoriasis. On the other hand, MSCs interact with DCs and various subsets of T cells, including Th1, Th2, Th17 and Tregs, to generate tolerogenic DCs and increase the differentiation of Tregs and modulate the Th17/Treg towards a regulatory state through overexpression of anti-inflammatory and immunomodulatory and immunomodulatory cytokines, including IL-10 and transforming growth Factor beta (TGF-β). Finally, we will focus on the challenges and obstacles in psoriasis treatment using MSCs, including limitations in the case of using MSCs from different sources and side effects that may be encountered by whole cell therapy strategies, which are attracting attention towards the implication of cell-free regimens such as using MSC-derived secretome or extracellular vesicles and exosomes to provide similar therapeutic outcomes without presumed side effects.

Mesenchymal stem cells attenuate diabetic vascular complication by reducing irregular extracellular matrix production in human blood vessel organoids

Mesenchymal stem cells (MSCs) hold potential for treating diabetic vascular complications, but current models fail to adequately replicate the complexities of diabetic vascular disease, limiting our ability to accurately assess their therapeutic effects. To this end, we developed a co-culture system using a combination of human embryonic stem cell-derived blood vessel organoids (BVOs) and MSCs. This system could accurately replicate key aspects of diabetic pathology, including basement membrane thickening and excessive extracellular matrix (ECM) deposition. The results showed that MSCs were effective in attenuating basement membrane thickening and reducing ECM deposition in BVOs under diabetic conditions. Subsequent transcriptomics demonstrated that the MSC-treated group exhibited a notable normalization of ECM-related gene expression, particularly in collagen IV levels. Furthermore, the inhibition of the NF-κB signaling pathway was identified as a crucial mechanism underlying the therapeutic efficacy of MSCs. This study demonstrates the potential of MSCs to counteract diabetic vascular complications and emphasizes the co-culture system as a more physiologically relevant model to investigate the preventive and therapeutic potential of MSCs in diabetic pathology.

Natural bioactive compounds modified with mesenchymal stem cells: new hope for regenerative medicine

Mesenchymal stem cells (MSCs) have the potential to differentiate into various cell types, providing important sources of cells for the development of regenerative medicine. Although MSCs have various advantages, there are also various problems, such as the low survival rate of transplanted cells and poor migration and homing; therefore, determining how to reform MSCs to improve their utilization is particularly important. Although many natural bioactive compounds have shown great potential for improving MSCs, many mechanisms and pathways are involved; however, in the final analysis, natural bioactive compounds promoted MSC proliferation, migration and homing and promoted differentiation and antiaging. This article reviews the regulatory effects of natural bioactive compounds on MSCs to provide new ideas for the therapeutic effects of modified MSCs on diseases.

Role of the tumor microenvironment in cancer therapy: unveiling new targets to overcome drug resistance

Cancer is a leading cause of death globally, with resistance to therapy representing a major obstacle to effective treatment. The tumor microenvironment (TME), comprising a complex network to cellular and non-cellular components including cancer-associated fibroblasts, immune cells, the extracellular matrix and region of hypoxia, is integral to cancer progression and therapeutic resistance. This review delves into the multifaceted interactions within the TME that contribute to tumor growth, survival and immune evasion. Key elements such as the role of cancer- associated fibroblasts in remodeling the extracellular matrix and promoting angiogenesis, the influence of immune cells such as tumor-associated macrophages in creating an immunosuppressive milieu and the impact of hypoxia conditions on metabolic adaptation and therapy resistance are thoroughly examined. This review evaluates current and emerging TME-targeted therapeutic strategies, including inhibitors of extracellular matrix components, modulators of immune cell activity and approached to alleviate hypoxia. Combination therapies that integrate TME-targeted agents with conventional treatments such as chemotherapy and immunotherapy are also discussed for their potential to enhance treatment efficacy and circumvent resistance mechanisms. By synthesising recent advances in TME research and therapeutic innovation, this paper aims to underscore the importance of TME in cancer therapy and highlight promising avenues for improving patient outcomes through targeted intervention.

Therapeutic application of extracellular vesicles in human diseases

Extracellular vesicles (EVs) are membrane vesicles released or secreted from almost all cell types. EVs are derived from multivesicular bodies or from the plasma membrane and contain a subset of proteins, lipids, and nucleic acids (e.g., DNA, RNA, and microRNA [miRNA]) derived from the parent cell. EVs play important roles in intercellular communication by efficiently transferring the content between cells both locally and systemically. Given their natural ability to transfer cargo to cells, sometimes in a targeted manner, and their apparent lack of immunogenicity, EVs are being engineered for delivery of therapeutic RNAs, DNAs, miRNAs, viral particles, drugs, and even proteins. In addition, many of the therapeutic effects of stem cell treatments are mediated by stem cell-derived EVs, which are safer and potentially more effective than the parental stem cells. Here we provide an overview of the use of EVs for delivery of different therapeutic nucleic acids, viruses, and drugs, as well as the use of therapeutic stem cell-derived EVs.

Neurological, functional, and quality of life outcomes following combined mesenchymal stem cell and Schwann cell therapy in spinal cord injury: a 9-year experience

BACKGROUND

Spinal cord injury (SCI) often results in severe disabilities and significant socioeconomic burdens.

OBJECTIVE

This study aimed to evaluate the effects and safety of co-transplantation of autologous bone marrow-derived mesenchymal stem cells (MSCs) and Schwann cells (SCs) via the intrathecal route in patients with complete spinal cord injury (SCI). The analysis focused on the therapy's impact across various SCI subgroups (cervical vs. thoracolumbar, subacute vs. chronic) and the factors influencing its efficacy.

METHODS

This case series evaluated 106 patients with complete SCI treated with combined cell therapy between August 2013 and September 2022, with a one-year follow-up. Safety profiles were assessed, and neurological and functional outcomes were measured using the American Spinal Injury Association (ASIA) scores, Spinal Cord Independence Measure (SCIM-III), and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) at 6- and 12-month intervals post-injection. Multiple regression analysis was conducted to evaluate factors associated with outcomes.

RESULTS

Significant improvements were observed in ASIA scores (motor, light touch, and pinprick), SCIM-III scores (total and subscales), and WHOQOL-BREF scores after 12 months. These improvements were consistent across subgroups, regardless of injury level or duration. Multiple regression analysis indicated that improvements in ASIA motor scores were associated with injury level, while improvements in SCIM-III total and mobility scores were associated with time since injury and patient age.

CONCLUSIONS

This study demonstrates significant neurological, functional, and quality of life improvements following combined cell therapy with autologous MSCs and SCs in patients with complete SCI. Future research should investigate potential synergies with other therapies and conduct comparative efficacy analyses.

Inhibition of CD45-specific phosphatase activity restores the differentiation potential of aged mesenchymal stromal cells: implications in regenerative medicine

BACKGROUND

Aging affects the reparative potency of mesenchymal stem/stromal cells (MSCs) by diminishing their proliferation and differentiation capability; making them unsuitable for regenerative purposes. Earlier we showed that MSCs acquire the expression of CD45 as a consequence of aging, and this increased expression is associated with downregulated expression of osteogenic markers and upregulated expression of adipogenic and osteoclastogenic markers. However, whether CD45 is actively involved in the aging-mediated deregulated differentiation in the MSCs was not elucidated.

RESULTS

In the present study, we showed that pharmacological inhibition of CD45-specific phosphatase activity in the aged MSCs restores their differentiation potential to young-like. Investigation of the molecular mechanism involved in the process showed that several regulatory kinases like p38, p44/42, Src, and GSK3β are in their dephosphorylated form in the aged MSCs, and importantly, this status gets reversed by the application of a CD45-specific PTP inhibitor. Conversely, pharmacological inhibition of these kinases in young MSCs imposes an aged-like gene expression profile on them. Additionally, we also showed that the secretome of aged MSCs affects the viability and differentiation of primary chondrocytes, and this detrimental effect is reversed by treating aged MSCs with the PTP inhibitor. Our data demonstrate that the aging-mediated expression of CD45 in MSCs alters their differentiation profile by dephosphorylating several kinases and treating the aged MSCs with a CD45 PTP activity inhibitor rejuvenates them.

CONCLUSIONS

CD45 can be used as an aging marker for mesenchymal stem cells. Alteration of CD45 phosphatase activity could have significant implications for the use of MSCs in regenerative medicine.

Physicochemical and Biological Modifications in Mesenchymal Stem Cells-Derived Conditioned Media Under Hypoxic Preconditioning: Impact on Oxidative Stress and Nanoparticle Stability

Hypoxic preconditioning (HP) is a promising approach to enhance the therapeutic efficacy of mesenchymal stem cells (MSCs) by modulating their oxidative stress response, metabolic activity, and secretome composition. Conditioned media (CM) obtained from MSCs cultured under hypoxia contains bioactive molecules and extracellular vesicles (EVs) that support regenerative processes. However, the effects of varying oxygen levels on the redox status and physicochemical characteristics of MSC-derived CM remain incompletely understood. This study aimed to investigate how two physiologically relevant oxygen concentrations (1% and 5%) influence oxidative stress parameters and nanoparticle features in Wharton's jelly-derived MSC (WJ-MSC)-conditioned media. Cells were cultured under 1% or 5% O2 and subjected to serum starvation for 48 or 72 h. CM samples were analyzed for total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI). Nanoparticle size and zeta potential were evaluated using dynamic light scattering (DLS), and HIF-1α levels were quantified via ELISA. Results showed that CM from 1% O2 cultures exhibited significantly higher oxidative stress, with elevated TOS and OSI values and reduced TAS levels, particularly after 72 h. Nanoparticle size was initially larger under 1% O2 but decreased with time, whereas 5% O2 supported more stable size profiles. Zeta potential measurements revealed more negative values under 5% O2, indicating greater colloidal stability. HIF-1α expression markedly increased under 1% O2, confirming hypoxia-induced cellular adaptation. In conclusion, this study demonstrates that graded hypoxia distinctly modulates oxidative stress and nanoparticle characteristics in MSC-derived CM. These findings provide a basis for optimizing hypoxic preconditioning protocols to improve the quality and therapeutic potential of acellular MSC-based therapies.

Nanoemulgel Development of Stem Cells from Human Exfoliated Deciduous Teeth-Derived Conditioned Medium as a Novel Nanocarrier Growth Factors

OBJECTIVE

 We aimed to develop a nanoemulgel of stem cells from human exfoliated deciduous teeth-derived conditioned medium (SHED-CM) for oral wound biotherapy candidate.

MATERIALS AND METHODS

 Deciduous tooth pulp was collected from two patients aged 6 years. The mesenchymal stem cell marker expression was analyzed by immunocytochemistry of CD45, CD90, and CD105. Alizarin red staining was performed to differentiate SHEDs from osteoblasts. The quantitative and quantification of transforming growth factor-β (TGF-β) and vascular endothelial growth factor (VEGF) secreted into conditioned media were measured using sodium dodecyl sulfate polyacrylamide gel electrophoresis and enzyme-linked immunosorbent assay. The characteristics of the nanoemulgel of SHED-CM (NESCM) were analyzed in terms of organoleptic properties, pH, and homogeneity. The cytotoxicity of NESCM 1.5% was analyzed in human gingival fibroblast (hGF) cell and osteoblast cell line (MC3T3) by 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay.

STATISTICAL ANALYSIS

 The results were presented as mean ± standard deviation (X ± SD), and the differences between groups were analyzed using the post hoc Tukey's test at a significance level of p-value < 0.05.

RESULTS

 SHEDs were successfully isolated, which were characterized for positive marker expressions of CD90 and CD105 and negative expression of CD45 as well as their osteogenic commitment. In SHED-CM, TGF-β and VEGF were detected on day 1 of conditioning and afterward. Notably, the growth factor enriched as the duration of conditioning increased. The generated nanoemulgel with SHED-CM was stable and homogeneous, and had limited cytotoxic effects on hGF and MC3T3 cell culture.

CONCLUSION

 SHED-CM containing the growth factors can potentially be used as oral wound biotherapy in the form of nanoemulgel.

Targeted Dual Microdroplets for Modulating Osteoclast Differentiation and Function: A Novel Therapeutic Approach to Combat Osteoporosis

Osteoporosis, a condition marked by reduced bone mass and structural deterioration, continues to be a major public health concern, especially as global populations age. Excessive osteoclast formation is a hallmark of osteoporosis. The transcription factor nuclear factor of activated T-cells cytoplasmic 1 (NFATc1) is indispensable for the early differentiation of osteoclasts, orchestrating the expression of essential genes, while at the later stages, cathepsin K (CTSK) is essential for bone resorption activities of mature osteoclasts. Here, we fabricated ultrasound-responsive microdroplets (MDs) by modulating both the early stages of osteoclast differentiation and the functions of mature osteoclasts via targeting the NFATc1 and CTSK. The internalization of these dual MDs was evaluated in human bone marrow-derived mesenchymal stromal cells (hBMSCs) and murine RAW 264.7 macrophages, alongside the biocompatibility assay. Their effects on osteogenesis and osteoclastogenesis were further investigated in vitro, followed by in vivo analysis in osteoporotic rat models. The dual MDs exhibited a well-defined core-shell structure and demonstrated efficient cellular uptake with minimal cytotoxicity. Furthermore, dual MDs showed a minimal effect on the osteogenic differentiation of the hBMSCs. In in vitro osteoclastogenesis assays, dual MDs effectively suppressed both osteoclast differentiation and formation through a synergistic inhibitory effect. In vivo studies demonstrated that osteoporotic rats receiving dual MDs showed significant protection against bone loss induced by ovariectomy. These results highlight the potential of dual MDs as a sophisticated, targeted therapeutic approach to osteoporosis treatment.

Advancements in Degenerative Disc Disease Treatment: A Regenerative Medicine Approach

Regenerative medicine represents a transformative approach to treating nucleus pulposus degeneration and offers hope for patients suffering from chronic low back pain due to disc degeneration. By focusing on restoring the natural structure and function of the nucleus pulposus rather than merely alleviating symptoms, these innovative therapies hold the potential to significantly improve patient outcomes. As research continues to advance in this field, we may soon witness a paradigm shift in how we approach spinal health and degenerative disc disease. The main purpose of this review is to provide an overview of the various regenerative approaches that target the restoration of the nucleus pulposus, a primary site for initiation of intervertebral disc degeneration.

Development of regenerative therapies targeting fibrotic endometrium in intrauterine adhesion or thin endometrium to restore uterine function

Intrauterine adhesions (IUA) and thin endometrium (TE) represent significant challenges in human reproduction. The condition arises frequently from damage to the endometrial basal layer, leading to fibrous tissue replacing the functional endometrium and impairing the uterus's ability to accept embryo implantation. Conventional treatments, mainly including hysteroscopic adhesiolysis and estrogen therapies, have shown limited success, particularly in severe cases. Regenerative medicine, with its focus on stem cell-based therapies and biomaterials, offers a promising avenue for restoring endometrial function and structure. This review synthesizes the current landscape of endometrial regeneration, focusing on the therapeutic potential of stem cells, the supportive role of biomaterials, and the importance of understanding molecular mechanisms to develop effective strategies for reconstruction of endometrial functional and fertility restoration.

Umbilical cord stem cells therapy against bacterial pneumonia based on zebrafish pneumonia model

Background

The increasing incidence and mortality rates of respiratory system diseases globally pose a significant public health challenge. Bacterial pneumonia is one of the leading risk factors for acute lung injury. Conventional antibiotics face inherent limitations, particularly the increase in bacterial resistance and inability to suppress inflammatory states, underscoring the urgent need for novel approaches to combat bacterial pneumonia.

Methods

This study evaluated the therapeutic effects of umbilical cord mesenchymal stem cells (UC-MSCs) on bacterial pneumonia in a zebrafish model, focusing on their impact on macrophage and neutrophil counts and their inhibitory effects on in vivo inflammatory responses. The anti-inflammatory mechanisms of UC-MSCs, including their effects on the secretion of inflammatory factors IL-1β, IL-6, and TNF-α, as well as their regulation of NLRP3, TLR4, and NF-kB mRNA expression and NLRP3, p65, and TLR4 protein levels, were further investigated.

Results

Our study found that UC-MSCs can effectively inhibit the development of bacterial pneumonia, primarily by reducing the number of macrophages and neutrophils and inhibiting the secretion of inflammatory factors IL-1β, IL-6, and TNF-α, thereby suppressing in vivo inflammatory reactions. Additionally, UC-MSCs significantly downregulated the expression of NLRP3, TLR4, and NF-kB mRNA, as well as the levels of NLRP3,TLR4, and p65 proteins.

Conclusion

UC-MSCs demonstrate promising potential in the treatment of bacterial pneumonia. This study provides important reference for the therapeutic effects and mechanisms of stem cell treatment of bacterial pneumonia, offering new avenues for clinical applications.

Extracellular vesicles derived from mesenchymal stem cells alleviate depressive-like behavior in a rat model of chronic stress

Depression is a prevalent chronic psychiatric disorder with a growing impact on global health. Current treatments often fail to achieve full remission, highlighting the need for alternative therapeutic strategies. Mesenchymal stem cells (MSCs) have attracted significant interest for their therapeutic potential in neuropsychiatric disorders, primarily due to their capacity to target neuroinflammation. This study aimed to investigate if extracellular vesicles derived from human umbilical MSCs (hucMSCs) promote behavioral beneficial actions in a rat model of chronic unpredictable mild stress (CUMS). We show that a single dose of hucMSCs or their derived EVs (hucMSC-EVs) via the tail vein alleviated depressive-like behavior in rats, reduced markers of neuroinflammation, reduced pro-inflammatory cytokines (IL-1β and TNF-α), and increased the number and dendritic complexity of DCX-positive cells in the dentate gyrus. Proteomic analysis of EVs revealed the presence of proteins involved in modulation of inflammatory processes and cell activation. Our study demonstrates EVs derived from hucMSCs can effectively mitigate depressive symptoms by modulating neuroinflammatory pathways and enhancing neurogenesis. These findings support further exploration of MSC-derived EVs as a novel therapeutic option for neuropsychiatric disorders.

Emerging Treatments for Persistent Corneal Epithelial Defects

Persistent corneal epithelial defects (PCEDs) are a challenging ocular condition characterized by the failure of complete corneal epithelial healing after an insult or injury, even after 14 days of standard care. There is a lack of therapeutics that target this condition and encourage re-epithelialization of the corneal surface in a timely and efficient manner. This review aims to provide an overview of current standards of management for PCEDs, highlighting novel, emerging treatments in this field. While many of the current non-surgical treatments aim to provide lubrication and mechanical support, novel non-surgical approaches are undergoing development to harness the proliferative and healing properties of human mesenchymal stem cells, platelets, lufepirsen, hyaluronic acid, thymosin ß4, p-derived peptide, and insulin-like growth factor for the treatment of PCEDs. Novel surgical treatments focus on corneal neurotization and limbal cell reconstruction using novel scaffold materials and cell-sources. This review provides insights into future PCED treatments that build upon current management guidelines.

UC-MSCs based on biomimetic microniche exert excellent regulatory effects on acute brain inflammation through advantageous properties

Neuroinflammation triggered by activated microglia leads to neuronal damage and, to a certain extent, neurodegeneration. Human umbilical cord mesenchymal stem cells (UC-MSCs) have good immunomodulatory and neuroprotective effects as well as therapeutic potential for neuroinflammation-related diseases. However, the complex microenvironment created by neuroinflammation poses a challenge to transplanted UC-MSCs. The emerging biomimetic microniche (BN)-based culture technology provides new opportunities to optimize the preparation of UC-MSCs; but the fundamental changes in the characteristics of UC-MSCs based on BN remain unclear, and more reliable preclinical data are needed to support their ability to regulate inflammation. Here, we systematically studied the cellular properties and inflammation regulatory capacity of UC-MSCs in conventional static planar culture (SP-UCMSCs) and suspension culture based on BN (BN-UCMSCs). In vitro, compared with SP-UCMSCs, BN-UCMSCs not only maintained the fundamental characteristics of MSCs, but also significantly enhanced cell proliferation, adhesion, and migration capabilities, etc; notably, the paracrine function and anti-inflammatory capacity of BN-UCMSCs were also enhanced. We further established a murine model of acute brain inflammation and demonstrated that the expression level of pro-inflammatory cytokines in hippocampal and cortical tissues of the BN-UCMSCs group was significantly decreased compared with that in the SP-UCMSCs group. Subsequent transcriptomic analysis of hippocampal and cortical tissues revealed that BN-UCMSCs had the advantage of significantly reducing the expression of pro-inflammatory cytokines through the TLR4-Myd88-NF-κB axis, which was further validated at the gene and protein levels. Taken together, these data strongly indicated that BN-UCMSCs exerts excellent regulatory effects on acute brain inflammation through advantageous properties.

Innovative approaches to boost mesenchymal stem cells efficacy in myocardial infarction therapy

Stem cell-based therapy has emerged as a promising approach for heart repair, potentially regenerating damaged heart tissue and improving outcomes for patients with heart disease. However, the efficacy of stem cell-based therapies remains limited by several challenges, including poor cell survival, low retention rates, poor integration, and limited functional outcomes. This article reviews current enhancement strategies to optimize mesenchymal stem cell therapy for cardiac repair. Key approaches include optimizing cell delivery methods, enhancing cell engraftment, promoting cell functions through genetic and molecular modifications, enhancing the paracrine effects of stem cells, and leveraging biomaterials and tissue engineering techniques. By focusing on these enhancement techniques, the paper highlights innovative approaches that can potentially transform stem cell therapy into a more viable and effective treatment option for cardiac repair. The ongoing research and technological advancements continue to push the boundaries, hoping to make stem cell therapy a mainstream treatment for heart disease.

Crosslinking stabilization strategy: A novel approach to cartilage-like repair of annulus fibrosus (AF) defects

Lumbar disc degeneration due to annulus fibrosus (AF) defects poses a significant challenge in clinical treatment Current treatments exhibit limited repair efficacy and a high recurrence rate. To address this, we devised a novel approach of crosslinking stabilization strategy. We integrated fibrinogen, thrombin, genipin, and human bone marrow-derived mesenchymal stem cells (hBMSCs) hydrogel (FTGB) with acellular scaffold and fascia (FTGB@S@F) to remediate AF defects. FTIR analysis confirmed stable chemical crosslinking within the FTGB hydrogel. FTGB hydrogel demonstrated superior biocompatibility compared to the FB hydrogel, with significantly higher cell viability (97.60 ± 2.02 % vs 81.43 ± 4.50 %, P < 0.01) and enhanced proliferation and migration, as shown in DAPI, Edu and phalloidin staining. Atomic force microscopy (AFM) revealed that FTGB@S has a dense reticular structure, enhancing material performance with higher elastic modulus than FB@S. MTS testing showed that FTGB@S@F outperformed other groups in resisting cyclic axial load (25.53 ± 1.17 MPa) and maintaining disc height (0.57 ± 0.12 mm), with stable axial compression resistance and minimal deformation. It also exhibited the lowest rupture ROM (1.45 ± 0.17 mm) and a rupture modulus close to the Intact control, demonstrating its potential to restore AF mechanical function. MRI imaging revealed that the FTGB@S@F group preserved an intact AF structure with high signal intensity, a significantly larger NP area (223.64 ± 73.32 mm2 vs 137.30 ± 75.31 mm2, P < 0.05), and higher disc height (102.5 ± 73.32 % vs 88.50 ± 12.86 %, P < 0.05). Histology confirmed superior AF repair and reduced NP degeneration in the FTGB@S@F group compared to the Un-repair and FB@S@F groups. Transcriptomic analysis identified upregulation of PIGR and downregulation of COL4A3, linked to the PI3K-Akt pathway. Immunohistochemical and qPCR analyses showed enhanced expression of COL1, Aggrecan, and RhoA, indicating effective regeneration.

Inhibition of GSK-3β Restores Differentiation Potential of Late-Passage Mesenchymal Stem Cells

Background/Objectives: Mesenchymal stem cells (MSCs) are regarded as a promising cell type with significant therapeutic benefits owing to their ease of isolation, maintenance, and characterisation. However, repeated passages during cultural maintenance frequently result in cellular senescence, limiting their utility in regenerative medicine. Methods: We investigated the differentiation capability between early- (P3) and late-passage MSCs (>P15) and tested the potential of Wnt agonist 99021 to reverse MSCs using standard cell culture protocols that define minimal criteria for MSCs, primarily tri-lineage differentiation assays, biochemical staining gene expression analysis, and senescence assays. Results: We initially noticed distinct signs of morphological aging between early- (P3) and late-passage MSCs (>P15) and further examined the differentiation capability between early- (P3) and late-passage MSCs (>P15). We found a diminished differentiation potential in late-passage MSCs. Our senescence assay also revealed >P15 cells were able to absorb the senescence dye, indicating that >P15 MSCs underwent senescence. We further demonstrated that CHIR 99021 reversed the differentiation inhibitory potential-mediated impasse of late-passage MSCs by employing tri-lineage specific differentiation assays, biochemical labelling, and gene expression analysis. Senescence assays after CHIR 99021 treatment also revealed no senescence dye uptake at all. Conclusions: Our findings demonstrated that CHIR 99021 Wnt agonist maybe aids in the reversal of MSC aging-related differentiation inhibition glitches and offers a proven demonstrated protocol for rejuvenating late-passage MSCs. Thus, CHIR99021 treatment inherently reverts the tri-lineage potency in late-passage MSCs, and this method could be further employed to ensure a plentiful MSC source for clinical purposes.

Mesenchymal stromal cells in bone marrow niche of patients with multiple myeloma: a double-edged sword

Multiple myeloma (MM) is a hematological malignancy defined by the abnormal proliferation and accumulation of plasma cells (PC) within the bone marrow (BM). While multiple myeloma impacts the bone, it is not classified as a primary bone cancer. The bone marrow microenvironment significantly influences the progression of myeloma and its treatment response. Mesenchymal stromal cells (MSCs) in this environment engage with myeloma cells and other bone marrow components via direct contact and the secretion of soluble factors. This review examines the established roles of MSCs in multiple facets of MM pathology, encompassing their pro-inflammatory functions, contributions to tumor epigenetics, effects on immune checkpoint inhibitors (ICIs), influence on reprogramming, chemotherapy resistance, and senescence. This review investigates the role of MSCs in the development and progression of MM.

Clinical translation of mesenchymal stem cells in ischemic heart failure: Challenges and future perspectives

Myocardial infarction (MI) with resulting congestive heart failure is one of the leading causes of death worldwide. Current therapies for treating MI, such as devices, traditional medicine, and surgeries, come with many limitations as patients in their final stages of heart failure have little chances of experiencing any reversible changes. In recent decades, Mesenchymal stem cell (MSC) based therapy has become one of the most popular and rapidly developing fields in treating MI. Their supremacy for clinical applications is partially due to their unique properties and encouraging pre-clinical outcomes in various animal disease models. However, the majority of clinical trials registered for MSC therapy for diverse human diseases, including MI, have fallen short of expectations. This review intends to discuss the recent advances in the clinical application of using MSCs for cardiac repair and discuss challenges facing the clinical translation of MSCs for cardiac regeneration such as restoration of endothelial-cardiomyocyte crosstalk, immunomodulation and immune rejection, poor homing and migration, as well as low retention and survival. Furthermore, we will discuss recent strategies being investigated to help overcome some of these challenges.

Mesenchymal stem cells therapy for the treatment of non-union fractures: a systematic review and meta-analysis

BACKGROUND

This meta-analysis aimed to pool the existing evidence to determine the clinical efficacy and safety of mesenchymal stem cells (MSC) in patients with non-unions.

METHODS

A systematic search in PubMed and Scopus was performed until October 2024 to gather pertinent studies. The inclusion criteria included participants with non-unions, the intervention of MSC administration, a comparator of standard treatment (bone graft), and outcomes focused on healing rate, healing time, or side effects. The Jadad score Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in randomized and non-randomized studies, respectively. Moreover, GRADE criteria were used to assess the quality of evidence. Using a random effects model, odds ratios (OR) with 95% confidence intervals (CIs) were calculated for healing and complication rates, while standardized mean differences (SMD) with their 95% CIs were used to assess the impact of MSC therapy on bone union time.

RESULTS

Twenty-one studies, with 866 patients, were included. The bone healing rates were 44% at 3 months, 73% at 6 months, 90% at 9 months, and 86% at 12 months, eventually reaching 91% after 12 months of follow-up. MSC therapy, with or without scaffolds, was linked to higher odds of bone healing rate at 3 and 6 months, compared to bone grafts as the standard care (OR = 1.69). The time to union following the treatment was 6.30 months (95%CI: 86-96%), with patients treated with MSC/Scaffold experiencing a shorter time compared to MSC alone (5.85 vs. 6.36 months). MSC therapy significantly decreased bone union time (SMD:-0.54 months, 95% CI: -0.75 to -0.33). The complication rate was 1% (MSC/Scaffold: 0%, MSC alone: 2%), with MSC alone or MSC/Scaffold showing a lower risk than the standard care (OR = 0.41, 95% CI: 0.22-0.78).

CONCLUSION

MSC is a potential adjunct therapy for patients with non-union fractures.

CLINICAL TRIAL NUMBER

Not applicable.

Regulation and functional importance of human periodontal ligament mesenchymal stromal cells with various rates of CD146+ cells

Introduction

Mesenchymal stromal cells (MSCs) with high expression of CD146 have superior properties for tissue regeneration. However, high variability in the rate of CD146+ cells among donors is observed. In this study, the possible reasons behind this variability in human periodontal ligament MSCs (hPDL-MSCs) were explored.

Methods

hPDL-MSCs were isolated from 22 different donors, and rates of CD146+ cells were analyzed by flow cytometry. Furthermore, populations with various rates of CD146+ cells were isolated with magnetic separation. The dependency of cell proliferation, viability, cell cycle, and osteogenic differentiation on the rates of CD146+ cells was investigated. Besides, the effects of various factors, like cell density, confluence, and inflammatory environment on the CD146+ rate and expression were analyzed.

Results

The rate of CD146+ cells exhibited high variability between donors, with the percentage of CD146+ cells ranging from 3% to 67%. Higher percentage of CD146+ cells was associated with higher proliferation, presumably due to the higher percentage of cells in the S-phase, and higher osteogenic differentiation potential. Prolonged cell confluence and higher cell seeding density led to the decline in the rate of CD146+ cells. The surface rate of CD146 in hPDL-MSCs was stimulated by the treatment with interleukin-1β and tumor necrosis factor-α, and inhibited by the treatment with interferon-γ.

Conclusion

These results suggest that hPDL-MSCs with high rate of CD146+ cells are a promising subpopulation for enhancing the effectiveness of MSC-based regenerative therapies, however the rate of CD146 is affected by various factors, which must be considered for cell propagation and their potential application in vivo.

Hybrid Biomembrane-Functionalized Nanorobots Penetrate the Vitreous Body of the Eye for the Treatment of Retinal Vein Occlusion

Intravitreal injections of antivascular endothelial growth factor (VEGF) agents are the primary method for treating retinal vein occlusion (RVO). However, the complex structure of eye anatomy presents ocular barriers that impede drug delivery. Additionally, these drugs only manage the complications associated with RVO and fail to address the underlying cause of vessel occlusions. Here, we describe a method that utilizes functionalized magnetically driven nanorobots to overcome ocular barriers and treat RVO. These nanorobots are developed using a hybrid biomembrane that combines stem cell membranes with liposome-derived membranes, enveloping perfluorohexane, iron oxide nanoparticles, and l-arginine. After intravitreal injection, the nanorobots can move directionally through and penetrate the vitreous body to reach the retina, driven by an external magnetic field. Subsequently, the nanorobots actively target the inflammation sites at occluded vessels due to the presence of stem cell membranes. In a rat model of RVO, enhanced targeting and accumulation in ischemic retinal vessels were demonstrated following intravitreal injections. Furthermore, the application of ultrasound triggers the release of l-arginine at the site of occlusion, stimulating the production of nitric oxide, which promotes vasodilation and restores blood flow, thereby achieving excellent therapeutic efficacy for RVO. We believe these methods hold significant promise for overcoming challenges in ocular drug delivery and effectively treating RVO in clinical applications.

Advanced nano delivery system for stem cell therapy for Alzheimer's disease

Alzheimer's Disease (AD) represents one of the most significant neurodegenerative challenges of our time, with its increasing prevalence and the lack of curative treatments underscoring an urgent need for innovative therapeutic strategies. Stem cells (SCs) therapy emerges as a promising frontier, offering potential mechanisms for neuroregeneration, neuroprotection, and disease modification in AD. This article provides a comprehensive overview of the current landscape and future directions of stem cell therapy in AD treatment, addressing key aspects such as stem cell migration, differentiation, paracrine effects, and mitochondrial translocation. Despite the promising therapeutic mechanisms of SCs, translating these findings into clinical applications faces substantial hurdles, including production scalability, quality control, ethical concerns, immunogenicity, and regulatory challenges. Furthermore, we delve into emerging trends in stem cell modification and application, highlighting the roles of genetic engineering, biomaterials, and advanced delivery systems. Potential solutions to overcome translational barriers are discussed, emphasizing the importance of interdisciplinary collaboration, regulatory harmonization, and adaptive clinical trial designs. The article concludes with reflections on the future of stem cell therapy in AD, balancing optimism with a pragmatic recognition of the challenges ahead. As we navigate these complexities, the ultimate goal remains to translate stem cell research into safe, effective, and accessible treatments for AD, heralding a new era in the fight against this devastating disease.

The therapeutic potential of mesenchymal stromal cell secretome in treating spontaneous chronic corneal epithelial defects in dogs

Corneal ulcers in dogs pose a significant challenge in veterinary ophthalmology, often leading to prolonged visual impairment and discomfort. This study aimed to assess the efficacy of adipose tissue-derived mesenchymal stromal cell (ASCs) secretome as a treatment for complicated corneal ulcers in dogs. Ten dogs with spontaneous chronic corneal epithelial defects, were treated with topical application of ASC secretome eye drops. Our results showed that secretome therapy facilitated complete healing of all corneal ulcers within 4 weeks, with an average healing time of 1.2 weeks. Notably, secretome treatment was effective even in cases that had previously failed to respond to conventional therapies. Clinical signs such as blepharospasm, conjunctival hyperemia, and photophobia were alleviated promptly following secretome administration. Secretome therapy was well-tolerated, with no adverse reactions reported, further supporting its safety profile. The findings suggest that ASC secretome represents a promising cell-free and minimally invasive therapeutic approach for the treatment of complicated corneal ulcers in dogs.

3D Mechanical Response Stem Cell Complex Repairs Spinal Cord Injury by Promoting Neurogenesis and Regulating Tissue Homeostasis

Spinal cord injury (SCI) leads to acute tissue damage that disrupts the microenvironmental homeostasis of the spinal cord, inhibiting cell survival and function, and thereby undermining treatment efficacy. Traditional stem cell therapies have limited success in SCI, due to the difficulties in maintaining cell survival and inducing sustained differentiation into neural lineages. A new solution may arise from controlling the fate of stem cells by creating an appropriate mechanical microenvironment. In this study, mechanical response stem cell complex (MRSCC) is created as an innovative therapeutic strategy for SCI, utilizing 3D bioprinting technology and gelatin microcarriers (GM) loaded with mesenchymal stem cells (MSCs). GM creates an optimal microenvironment for MSCs growth and paracrine activity. Meanwhile, 3D bioprinting allows accurate control of spatial pore architecture and mechanical characteristics of the cell construct to encourage neuroregeneration. The mechanical microenvironment created by MRSCC is found to activate the Piezo1 channel and prevent excessive nuclear translocation of YAP, thereby increasing neural-related gene expression in MSCs. Transplanting MRSCC in rats with spinal cord injuries boosts sensory and motor recovery, reduces inflammation, and stimulates the regeneration of neurons and glial cells. The MRSCC offers a new tissue engineering solution that can promote spinal cord repair.

Mesenchymal Stem Cell Secretome: Potential Applications in Human Infertility Caused by Hormonal Imbalance, External Damage, or Immune Factors

Mesenchymal stem cells (MSCs) are a source of a wide range of soluble factors, including different proteins, growth factors, cytokines, chemokines, and DNA and RNA molecules, in addition to numerous secondary metabolites and byproducts of their metabolism. MSC secretome can be formally divided into secretory and vesicular parts, both of which are very important for intercellular communication and are involved in processes such as angiogenesis, proliferation, and immunomodulation. Exosomes are thought to have the same content and function as the MSCs from which they are derived, but they also have a number of advantages over stem cells, including low immunogenicity, unaltered functional activity during freezing and thawing, and a lack of tumor formation. In addition, MSC pre-treatment with various inflammatory factors or hypoxia can alter their secretomes so that it can be modified into a more effective treatment. Paracrine factors secreted by MSCs improve the survival of other cell populations by several mechanisms, including immunomodulatory (mostly anti-inflammatory) activity and anti-apoptotic activity partly based on Hsp27 upregulation. Reproductive medicine is one of the fields in which this cell-free approach has been extensively researched. This review presents the possible applications and challenges of using MSC secretome in the treatment of infertility. MSCs and their secretions have been shown to have beneficial effects in various models of female and male infertility resulting from toxic damage, endocrine disorders, trauma, infectious agents, and autoimmune origin.

Therapeutic effect of long-interval repeated subcutaneous administration of canine amniotic membrane-derived mesenchymal stem cells in atopic dermatitis mouse model

Atopic dermatitis (AD) is a chronic and inflammatory disease. According to a recent study, administration of canine MSCs is a potential therapy for immunological diseases. However, most related studies involve short-term experiments and acute atopic dermatitis animal models. Thus, studies of repeated subcutaneous injection of canine MSCs for ameliorating long-term inflammatory skin disorders have not yet been established. In this study, we evaluated the effects of long-term canine amniotic mesenchymal stem cells (cAM-MSCs) and calcineurin inhibitors (CNIs) treatments in mouse AD model for up to 8 weeks and compared the differences in therapeutic effect through canine peripheral blood mononuclear cells (PBMCs). Using a mouse model, we validated the therapeutic impact of cAM-MSCs in comparison to pimecrolimus (Pime), the most widely used CNIs, as a therapy for canine AD. Based on our results, we verified that the cAM-MSC treatment group exhibited substantially lower scores for tissue pathologic alterations, inflammatory cytokines, and dermatologic symptoms than the PBS control group. Importantly, compared with Pime, cAM-MSCs were more effective at preventing wound dysfunction and regulating mast cell activity. Additionally, we confirmed that immune modulation proteins (TGF-β1, IDO1, and COX-2) were increased in the cAM-MSCs treatment group. Furthermore, we examined the immunoregulatory effect of cAM-MSCs through the proliferation of T lymphocytes from activated canine PBMCs. As a result, cAM-MSCs suppressed the proliferative capacity of effector T cells from canine PBMCs more effectively than Pime. In conclusion, this study suggested that the cAM-MSCS could be an effective canine treatment for long-term canine AD through regeneration and immunomodulation.

Preclinical Evaluation of the Safety, Toxicity and Efficacy of Genetically Modified Wharton's Jelly Mesenchymal Stem/Stromal Cells Expressing the Antimicrobial Peptide SE-33

Mesenchymal stem/stromal cells (MSCs) offer promising therapeutic potential in cell-based therapies for various diseases. However, the safety of genetically modified MSCs remains poorly understood. This study aimed to evaluate the general toxicity and safety of Wharton's Jelly-Derived MSCs (WJ-MSCs) engineered to express the antimicrobial peptide SE-33 in an animal model. Genetically modified WJ-MSCs expressing SE-33 were administered to C57BL/6 mice at both therapeutic and excessive doses, either once or repeatedly. Animal monitoring included mortality, clinical signs, and behavioral observations. The toxicity assessment involved histopathological, hematological, and biochemical analyses of major organs and tissues, while immunotoxicity and immunogenicity were examined through humoral and cellular immune responses, macrophage phagocytic activity, and lymphocyte blast transformation. Antimicrobial efficacy was evaluated in a Staphylococcus aureus-induced pneumonia model by monitoring animal mortality and assessing bacterial load and inflammatory processes in the lungs. Mice receiving genetically modified WJ-MSCs exhibited no acute or chronic toxicity, behavioral abnormalities, or pathological changes, regardless of the dose or administration frequency. No significant immunotoxicity or alterations in immune responses were observed, and there were no notable changes in hematological or biochemical serum parameters. Infected animals treated with WJ-MSC-SE33 showed a significant reduction in bacterial load and lung inflammation and improved survival compared to control groups, demonstrating efficacy over native WJ-MSCs. Our findings suggest that WJ-MSCs expressing SE-33 are well tolerated, displaying a favorable safety profile comparable to native WJ-MSCs and potent antimicrobial activity, significantly reducing bacterial load, inflammation, and mortality in an S. aureus pneumonia model. These data support the safety profile of WJ-MSCs expressing SE-33 as a promising candidate for cell-based therapies for bacterial infections, particularly those complicated by antibiotic resistance.

Activation of angiopoietin-1 signaling with engineering mesenchymal stem cells promoted efficient angiogenesis in diabetic wound healing

BACKGROUND

Vascular insufficiency is associated with the pathogenesis and therapeutic outcomes of diabetic foot ulcers (DFU). While mesenchymal stem cells (MSCs) hold potential for DFU treatment, further enhancement in promoting angiogenesis in the challenging DFU wounds is imperative.

METHODS

The differential expression of pro- and anti-angiogenic factors during both normal and diabetic wound healing was compared using quantitative PCR. MSCs derived from the umbilical cord was prepared, and the engineered MSC (MSCANG1) overexpressing both the candidate pro-angiogenic gene, angiopoietin-1 (ANG1), and green fluorescent protein (GFP) was constructed using a lentiviral system. The pro-vascular stabilizing effects of MSCANG1 were assessed in primary endothelial cell cultures. Subsequently, MSCANG1 was transplanted into streptozotocin (STZ)-induced diabetic wound models to evaluate therapeutic effects on angiogenesis and wound healing. The underlying mechanisms were further examined both in vitro and in vivo.

RESULTS

The comprehensive analysis of the temporal expression of pro- and anti-angiogenic factors revealed a consistent impairment in ANG1 expression throughout diabetic wound healing. MSCANG1 exhibited robust EGFP expression in 80% of cells, with overexpression and secretion of the ANG1 protein. MSCANG1 notably enhanced the survival and tubulogenesis of endothelial cells and promoted the expression of junction proteins, facilitating the establishment of functional vasculature with improved vascular leakage. Although MSCANG1 did not enhance the survival of engrafted MSCs in diabetic wounds, it significantly promoted angiogenesis in diabetic wound healing, fostering the establishment of stable vasculature during the healing process. Activation of the protein kinase B (Akt) pathway and suppression of proto-oncogene tyrosine kinase Src (Src) activity in MSCANG1-treated diabetic wounds confirmed efficient angiogenesis process. Consequently, epidermal and dermal reconstruction, as well as skin appendage regeneration were markedly accelerated in MSCANG1-treated diabetic wounds compared to MSC-treated wounds.

CONCLUSION

Treatment with MSCs alone promotes angiogenesis and DFU healing, while the engineering of MSCs with ANG1 provides substantial additional benefits to this therapeutic process. The engineering of MSCs with ANG1 presents a promising avenue for developing innovative strategies in managing DFU.

Mesenchymal stem cells and mesenchymal stem cell-derived exosomes: a promising strategy for treating retinal degenerative diseases

Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic strategy in regenerative medicine, demonstrating significant potential for clinical applications. Evidence suggests that MSCs not only exhibit multipotent differentiation potential but also exert critical therapeutic effects in retinal degenerative diseases via robust paracrine mechanisms. MSCs protect retinal cells from degenerative damage by modulating inflammation, inhibiting apoptosis, alleviating oxidative stress, and suppressing cell death pathways. Furthermore, MSCs contribute to retinal structural and functional stability by facilitating vascular remodeling and donating mitochondria to retinal cells. Of particular interest, MSC-derived exosomes have gained widespread attention as a compelling cell-free therapy. Owing to their potent anti-inflammatory, anti-apoptotic, and vascular-stabilizing properties, exosomes show significant promise for the treatment of retinal degenerative diseases.

Emerging Role of Mesenchymal Stromal Cell and Exosome Therapies in Treating Cognitive Impairment

Cognitive aging, characterized by the gradual decline in cognitive functions such as memory, attention, and problem-solving, significantly impacts daily life. This decline is often accelerated by neurodegenerative diseases, particularly Alzheimer's Disease (AD) and Parkinson's Disease (PD). AD is marked by the accumulation of amyloid-beta plaques and tau tangles, whereas PD involves the degeneration of dopaminergic neurons. Both conditions lead to severe cognitive impairment, greatly diminishing the quality of life for affected individuals. Recent advancements in regenerative medicine have highlighted mesenchymal stromal cells (MSCs) and their derived exosomes as promising therapeutic options. MSCs possess regenerative, neuroprotective, and immunomodulatory properties, which can promote neurogenesis, reduce inflammation, and support neuronal health. Exosomes, nanosized vesicles derived from MSCs, provide an efficient means for delivering bioactive molecules across the blood-brain barrier, targeting the underlying pathologies of AD and PD. While these therapies hold great promise, challenges such as variability in MSC sources, optimal dosing, and effective delivery methods need to be addressed for clinical application. The development of robust protocols, along with rigorous clinical trials, is crucial for validating the safety and efficacy of MSC and exosome therapies. Future research should focus on overcoming these barriers, optimizing treatment strategies, and exploring the integration of MSC and exosome therapies with lifestyle interventions. By addressing these challenges, MSC- and exosome-based therapies could offer transformative solutions for improving outcomes and enhancing the quality of life for individuals affected by cognitive aging and neurodegenerative diseases.

Secretome Analysis of Human and Rat Pancreatic Islets Co-Cultured with Adipose-Derived Stromal Cells Reveals a Signature with Enhanced Regenerative Capacities

Pancreatic islet transplantation (PIT) is a promising treatment for type 1 diabetes (T1D) but faces challenges pre- and post-transplantation. Co-transplantation with mesenchymal stromal cells (MSCs), known for their regenerative properties, has shown potential in improving PIT outcomes. This study examined the secretome of islets cultured alone compared to the secretomes of islets co-cultured with adipose-derived stromal cells (ASCs), a subtype of MSCs, under transplantation-relevant stressors: normoxia, cytokines, high glucose, hypoxia, and combined hypoxia and high glucose. Islet co-culture with ASCs significantly altered the proteome, affecting pathways related to energy metabolism, angiogenesis, extracellular matrix organization, and immune modulation. Key signaling molecules (e.g., VEGF, PDGF, bFGF, Collagen I alpha 1, IL-1α, and IL-10) were differentially regulated depending on culture conditions and ASC presence. Functional assays demonstrated that the co-culture secretome could enhance angiogenesis, collagen deposition, and immune modulation, depending on the stress conditions. These findings highlight possible mechanisms through which ASCs may support islet survival and function, offering insights into overcoming PIT challenges. Moreover, this work contributes to identifying biomarkers of the post-transplantation microenvironment, advancing therapeutic strategies for T1D and regenerative medicine.