Prospects of mesenchymal stem cell therapy in IBD: focus on the impact of autophagy

Inflammatory bowel disease (IBD) is a chronic and currently incurable intestinal disorder, with existing treatments often being limited and burdened by challenges. Mesenchymal stem cell (MSC) therapy has emerged as a highly promising therapeutic strategy, primarily due to its profound immunomodulatory and tissue-reparative capabilities. Autophagy, an essential cellular homeostatic process, is deeply implicated in both the pathogenesis of IBD and the biological functions of MSCs. This review consolidates current knowledge on the critical role of autophagy within MSC-based treatment paradigms for IBD. We examine how MSCs and their derived extracellular vesicles (EVs) alleviate intestinal inflammation, and conversely, how autophagy regulates vital MSC properties such as cellular survival, differentiation potential, and immunomodulatory activity. A deeper understanding of this bidirectional interaction provides innovative insights for enhancing the therapeutic efficacy of MSCs. Ultimately, strategically modulating autophagy in conjunction with MSC therapy represents a meaningful and promising frontier for developing novel and effective treatments against IBD.