REVIEW article
Front. Cell Dev. Biol.
Sec. Stem Cell Research
Volume 13 - 2025 | doi: 10.3389/fcell.2025.1621289
This article is part of the Research TopicThe Importance of Stem Cell Regeneration in Tissue Repair: Understanding Influences of the MicroenvironmentView all 3 articles
Mechanistic insights into adipose-derived stem cells and exosomes in ischemia-reperfusion injury repair: from shared pathways to organspecific therapeutics
Provisionally accepted
- 1First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
- 2The Affiliated Yiwu hospital of Wenzhou Medical University, Yiwu City, Zhejiang Province, China
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Ischemia-reperfusion injury (IRI) has become a significant challenge for clinical treatment due to the complex multi-mechanism pathological cascade response, including oxidative stress, inflammatory bursts, and programmed cell death. Adipose-derived stem cells (ADSCs) and their exosomes (ADSCs-exosomes) are emerging as a breakthrough therapeutic strategy to reverse IRI, owing to their multi-target synergistic effects. This review systematically analyzes the two major repair modes of ADSCs and ADSCs-exosomes: the "common protection" mechanism, which includes antiinflammatory, anti-oxidative, and anti-apoptotic effects through paracrine regulation of miRNAs targeting the NF-κB/NRF2/β-catenin signaling axis; and precision repair, which is achieved through organ-specific targets, including hepatic mitochondrial dynamics and pyroptosis inhibition, cardiac macrophage polarization and neutrophil clearance, renal anti-fibrosis and erythropoietin (EPO) activation, as well as brain iron death regulation and microglial remodeling.From the perspective of the mechanism interaction network, this paper first proposes a theoretical framework of "multi-organ shared core pathways and dynamic regulation of different targets." It also reviews the translational potential of combined therapeutic strategies based on engineered exosomes delivery systems and biomaterials, emphasizing the optimization of delivery efficiency and functional enhancement to address the bottleneck of clinical applications. The ADSCs-mediated IRI intervention system provides an essential theoretical and technical basis for the development of individualized precision therapies.
Keywords: adipose-derived stem cells, Exosomes, ischemia-reperfusion injury, multimechanism synergy, therapeutic strategy
Received: 30 Apr 2025; Accepted: 09 Jun 2025.
Copyright: © 2025 Si, Wang, Dai, Lv, Zhao, Chen, Li, Ding and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Siqi Ding, The Affiliated Yiwu hospital of Wenzhou Medical University, Yiwu City, Zhejiang Province, China
Yucang He, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
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