Current perspectives on regenerative potential of mesenchymal stem cells in alleviating cardiac injuries: Molecular pathways and therapeutic enhancement

Mesenchymal stem cells (MSCs) derived from bone marrow or adipose tissue have promising potential in regenerative medicine. The regenerative capacity of MSCs depends on their successful migration and engraftment at the injured site. Several preclinical and clinical studies have reported that MSCs effectively treat cardiac dysfunction. However, significant obstacles to MSC homing include peripheral sequestration and low survival rates. MSC-secreted extracellular vesicles exhibit effects similar to those of MSCs, contributing to cellular proliferation, differentiation, and various paracrine functions. This review explores the molecular pathways and mechanisms by which MSCs and extracellular vesicles modulate cardiac injuries. Additionally, we discuss the challenges associated with MSC homing and various strategies to enhance the process.