Mesenchymal stem cell secretome and exosomes as potential advanced therapy medicinal products for treating a failing heart

Heart failure results in impaired cardiac systolic and/or diastolic functions. Traditional pharmacological and non-pharmacological approaches provide, at best, only short-term symptomatic relief, and the long-term prognosis remains poor. Regenerative medicine, particularly mesenchymal stem cells (MSCs), presents a promising alternative for cardiac repair. Ye and Liu published a study in the recent issue of World Journal of Stem Cell highlights the cell-free therapy approach, focusing on the therapeutic potential of MSC-derived paracrine secretions, which exert crucial pleiotropic effects on cardiac repair and regeneration. Their mechanisms involve the seven primary modules that promote angiogenesis, inhibit apoptosis, reduce oxidative stress, modulate inflammatory responses, facilitate cardiomyogenesis, and reduce myocardial fibrosis. Furthermore, their complex repair mechanisms, regenerative pathways, and emerging strategies, which bring us a step closer to their clinical translation, have been discussed as part of the future perspective. While MSC-derived secretomes and exosomes show immense promise for myocardial reparability and improving cardiac function, further research is warranted to fully understand their roles, optimize techniques, and establish their safety and effectiveness for clinical use.