Safwan M, Bourgleh MS, Al-Ruqi A, Shrebaty O, Almujaydil F, AlOthaim B, AlRashidi N, Haider KH. Living bio-drug therapies using mesenchymal stem cells and exosomes for mechanically ventilated patients with acute respiratory distress syndrome: A systematic review and meta-analysis. World J Stem Cells 2025; 17(10): 111978 [DOI: 10.4252/wjsc.v17.i10.111978]
Corresponding Author of This Article
Khawaja Husnain Haider, PhD, Professor, Department of Basic Sciences, Sulaiman Al Rajhi University, PO Box 777, Al Bukairiyah 51941, AlQaseem, Saudi Arabia. khhaider@gmail.com
Research Domain of This Article
Cell & Tissue Engineering
Article-Type of This Article
Meta-Analysis
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 26, 2025 (publication date) through Oct 27, 2025
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Journal Information of This Article
Publication Name
World Journal of Stem Cells
ISSN
1948-0210
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Safwan M, Bourgleh MS, Al-Ruqi A, Shrebaty O, Almujaydil F, AlOthaim B, AlRashidi N, Haider KH. Living bio-drug therapies using mesenchymal stem cells and exosomes for mechanically ventilated patients with acute respiratory distress syndrome: A systematic review and meta-analysis. World J Stem Cells 2025; 17(10): 111978 [DOI: 10.4252/wjsc.v17.i10.111978]
World J Stem Cells. Oct 26, 2025; 17(10): 111978 Published online Oct 26, 2025. doi: 10.4252/wjsc.v17.i10.111978
Living bio-drug therapies using mesenchymal stem cells and exosomes for mechanically ventilated patients with acute respiratory distress syndrome: A systematic review and meta-analysis
Moaz Safwan, Mariam Safwan Bourgleh, Abdulsalam Al-Ruqi, Omran Shrebaty, Faisal Almujaydil, Basel AlOthaim, Nasser AlRashidi, Khawaja Husnain Haider, Department of Basic Sciences, Sulaiman Al Rajhi University, Al Bukairiyah 51941, AlQaseem, Saudi Arabia
Co-first authors: Moaz Safwan and Mariam Safwan Bourgleh.
Author contributions: Safwan M, Bourgleh MS, and Haider KH participated in manuscript writing; Haider KH designed the study protocol, revised the manuscript, and submitted the paper to the journal; Safwan M registered the study protocol on PROSPERO and performed data extraction; Bourgleh MS performed the statistical analysis; Al-Ruqi A and Shrebaty O performed database screening and reports inclusion; Almujaydil F, AlOthaim B, and AlRashidi N conducted data extraction and quality assessment of the included reports. Safwan M and Bourgleh MS contributed equally to this manuscript and are co-first authors.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Khawaja Husnain Haider, PhD, Professor, Department of Basic Sciences, Sulaiman Al Rajhi University, PO Box 777, Al Bukairiyah 51941, AlQaseem, Saudi Arabia. khhaider@gmail.com
Received: July 15, 2025 Revised: August 28, 2025 Accepted: October 13, 2025 Published online: October 26, 2025 Processing time: 102 Days and 9.3 Hours
Core Tip
Core Tip: Mesenchymal stem cells, as a living bio-drug, are being considered as a potential treatment for coronavirus disease 2019-induced acute respiratory distress syndrome due to their immunomodulatory and reparative properties. Our systematic review and meta-analysis, involving 16 randomized controlled trials (n = 1027 acute respiratory distress syndrome patients), is the first study to directly compare the therapeutic benefits of mesenchymal stem cell-based and their derivative exosome-based therapeutic approaches. Although we did not find significant differences in their safety profiles and efficacy, the exosome-based treatment ranked higher in terms of therapeutic benefits in a network meta-analysis, offering practical and logistical advantages.
