From scarring to healing: Emerging regenerative therapies for pulmonary fibrosis using MSCs and exosomes

Abstract Background Pulmonary fibrosis is a progressive and often fatal disease featuring the disruption of lung architecture by excessive extracellular matrix deposition. Main Body Mesenchymal stem cells (MSCs) have strong immunomodulatory, anti‐inflammatory and regenerative capacities that enable them to restore lung function through the targeting of key fibrotic mechanisms. Their migration into sites of injury and interaction with immune and structural cells through cytokines and growth factors underlines their therapeutic value. Recently, exosomes derived from MSCs have emerged as a promising cell‐free treatment option capable of crossing biological barriers and delivering anti‐fibrotic molecules like miRNAs, siRNAs, and proteins directly to fibrotic tissues. These vesicles enhance therapeutic precision and safety compared with cell therapy. Despite challenges in standardization, large‐scale production, and heterogeneity among MSCs sources, ongoing advances in biotechnology and clinical trial design are rapidly bridging the gap between preclinical promise and clinical application. Conclusion This present review discusses the pathogenesis and modelling of pulmonary fibrosis and underlines MSCs and exosome‐based regenerative strategies as an effective and transforming approach in the future therapy of pulmonary fibrosis.