Trends and Frontiers in Stem Cell Research for Sepsis: A Bibliometric Analysis (1990–2025)

Purpose: To systematically map the 35-year intellectual evolution of stem cell research in sepsis and identify emerging frontiers for clinical translation. Methods: We retrieved 3890 publications (1990– 2025) from the Web of Science Core Collection. Multi-dimensional bibliometric analyses, including co-citation networks, keyword bursts, and alluvial flow mapping, were performed using CiteSpace, HistCite, and R to delineate the field’s trajectory. Results: Annual publications increased significantly, peaking in 2024, with the USA and China as primary contributors. The research focus has undergone a major paradigm shift: from early "bone marrow transplantation” and hematopoietic reconstitution (1990s– 2000s) to the immunomodulatory mechanisms of "mesenchymal stem cells” (2010s). Currently, the field has entered a "cell-free” era, characterized by intense research into "extracellular vesicles” and "exosomes” (2021– 2025). Alluvial analysis identified "cancer”, "immunotherapy”, and "COVID-19” as dominant integrated modules. Notably, the emergence of "guidelines” and "precision care” highlights a growing emphasis on clinical standardization and targeted treatment for sepsis-induced organ failure. Conclusion: This study demonstrates that the frontier of sepsis therapy is moving toward refined, secretome-based biologics. Our findings provide a strategic roadmap for researchers to prioritize high-potential therapeutic targets and for clinicians to design more focused trials, ultimately accelerating the integration of stem cell-derived products into mainstream sepsis management.