Cell and Tissue Research

, Volume 374, Issue 1, pp 1–15 | Cite as

Mesenchymal stromal cell-derived extracellular vesicles: regenerative and immunomodulatory effects and potential applications in sepsis

  • Guoping Zheng
  • Ruoqiong Huang
  • Guanguan Qiu
  • Menghua Ge
  • Jiangmei Wang
  • Qiang Shu
  • Jianguo XuEmail author


Mesenchymal stromal (stem) cells (MSCs) have multipotent differentiation capacity and exist in nearly all forms of post-natal organs and tissues. The immunosuppressive and anti-inflammatory properties of MSCs have made them an ideal candidate in the treatment of diseases, such as sepsis, in which inflammation plays a critical role. One of the key mechanisms of MSCs appears to derive from their paracrine activity. Recent studies have demonstrated that MSC-derived extracellular vesicles (MSC-EVs) are at least partially responsible for the paracrine effect. MSC-EVs transfer molecules (such as proteins/peptides, mRNA, microRNA and lipids) with immunoregulatory properties to recipient cells. MSC-EVs have been shown to mimic MSCs in alleviating sepsis and may serve as an alternative to whole cell therapy. Compared with MSCs, MSC-EVs may offer specific advantages due to lower immunogenicity and higher safety profile. The first two sections of the review discuss the preclinical and clinical findings of MSCs in sepsis. Next, we review the characteristics of EVs and MSC-EVs. Then, we summarize the mechanisms of MSC-EVs, including tissue regeneration and immunomodulation. Finally, our review presents the evidences that MSC-EVs are effective in treating models of sepsis. In conclusion, MSC-EVs may have the potential to become a novel therapeutic strategy for sepsis.


Mesenchymal stromal (stem) cells Extracellular vesicles Exosomes Mesenchymal stromal cell-derived extracellular vesicles Sepsis 



This work was supported by the National Natural Science Foundation of China (81671956) and the Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents (2016-6) to QS and the National Natural Science Foundation of China (81570071 and 81772122) to JX.

Author contributions

GZ, QS and JX contributed to the concept of the review. GZ, RH, GQ, MG, JW, QS and JX were responsible for study selection and writing of the manuscript. GZ, QS and JX contributed to a critical review of the manuscript.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Shaoxing Second HospitalShaoxingChina
  2. 2.The Children’s Hospital of Zhejiang University School of MedicineHangzhouChina
  3. 3.The First Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina

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