Mesenchymal stem cells (MSCs) have been extensively investigated for the treatment of various diseases. The therapeutic potential of MSCs is attributed to complex cellular and molecular mechanisms of action including differentiation into multiple cell lineages and regulation of immune responses via immunomodulation. The plasticity of MSCs in immunomodulation allow these cells to exert different immune effects depending on different diseases. Understanding the biology of MSCs and their role in treatment is critical to determine their potential for various therapeutic applications and for the development of MSC-based regenerative medicine. This review summarizes the recent progress of particular mechanisms underlying the tissue regenerative properties and immunomodulatory effects of MSCs. We focused on discussing the functional roles of paracrine activities, direct cell–cell contact, mitochondrial transfer, and extracellular vesicles related to MSC-mediated effects on immune cell responses, cell survival, and regeneration. This will provide an overview of the current research on the rapid development of MSC-based therapies.

间充质干细胞（MSC）已被广泛研究用于治疗各种疾病。间充质干细胞的治疗潜力归因于复杂的细胞和分子作用机制，包括分化为多种细胞谱系以及通过免疫调节调节免疫反应。间充质干细胞在免疫调节方面的可塑性使得这些细胞能够根据不同的疾病发挥不同的免疫作用。了解 MSC 的生物学及其在治疗中的作用对于确定其在各种治疗应用中的潜力以及基于 MSC 的再生医学的发展至关重要。本综述总结了 MSC 的组织再生特性和免疫调节作用的特定机制的最新进展。我们重点讨论了旁分泌活动、直接细胞间接触、线粒体转移和细胞外囊泡与 MSC 介导的免疫细胞反应、细胞存活和再生作用相关的功能作用。这将概述当前基于 MSC 的疗法快速发展的研究。