Mesenchymal stromal cells (MSCs) have attracted great interest in the field of regenerative medicine. They can home to damaged tissue, where they can exert pro-regenerative and anti-inflammatory properties. These therapeutic effects involve the secretion of growth factors, cytokines, and chemokines. Moreover, the functions of MSCs could be mediated by extracellular vesicles (EVs) that shuttle various signaling messengers. Although preclinical studies and clinical trials have demonstrated promising therapeutic results, the efficiency and the safety of MSCs need to be improved. After transplantation, MSCs face harsh environmental conditions, which likely dampen their therapeutic efficacy. A possible strategy aiming to improve the survival and therapeutic functions of MSCs needs to be developed. The preconditioning of MSCs ex vivo would strength their capacities by preparing them to survive and to better function in this hostile environment. In this review, we will discuss several preconditioning approaches that may improve the therapeutic capacity of MSCs. As stated above, EVs can recapitulate the beneficial effects of MSCs and may help avoid many risks associated with cell transplantation. As a result, this novel type of cell-free therapy may be safer and more efficient than the whole cell product. We will, therefore, also discuss current knowledge regarding the therapeutic properties of MSC-derived EVs.

中文翻译：

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提高间充质基质细胞治疗安全性和效率的新见解。

间充质基质细胞（MSC）引起了再生医学领域的极大兴趣。它们可以归巢于受损组织，发挥促再生和抗炎特性。这些治疗作用涉及生长因子、细胞因子和趋化因子的分泌。此外，间充质干细胞的功能可以通过穿梭各种信号信使的细胞外囊泡（EV）介导。尽管临床前研究和临床试验已经证明了有希望的治疗结果，但间充质干细胞的效率和安全性仍需提高。移植后，间充质干细胞面临恶劣的环境条件，这可能会削弱其治疗效果。需要开发一种旨在提高间充质干细胞的存活和治疗功能的可能策略。间充质干细胞的离体预处理将增强它们的能力，让它们在这种恶劣的环境中生存并更好地发挥作用。在这篇综述中，我们将讨论几种可能提高 MSC 治疗能力的预处理方法。如上所述，EV 可以重现 MSC 的有益作用，并可能有助于避免与细胞移植相关的许多风险。因此，这种新型的无细胞疗法可能比全细胞产品更安全、更有效。因此，我们还将讨论有关 MSC 衍生的 EV 治疗特性的当前知识。