Mesenchymal stem cell secretome and exosomes as potential advanced therapy medicinal products for treating a failing heart

Figure 1 Mesenchymal stem cell secretome and exosomal cargo-mediated mechanisms of cardiac repair. The figure created by BioRender (Supplementary material). This schematic illustrates the multifaceted roles of mesenchymal stem cell-derived secretome (represented by rectangular boxes) and exosome cargo (represented by circular elements) in promoting cardiac repair following heart failure. The injured myocardium at the center is surrounded by seven key regenerative mechanisms, each involving distinct molecular components and biological pathways as discussed in the text. VEGF: Vascular endothelial growth factor; FGF2: Fibroblast growth factor 2; PDGF: Platelet-derived growth factor; TGF-β: Transforming growth factor beta; HGF: Hepatocyte growth factor; IGF-1: Insulin-like growth factor 1; Bcl-2: B-cell lymphoma 2; PDCD4: Programmed cell death protein 4; Bim: B-cell lymphoma 2-interacting mediator of cell death; IL-10: Interleukin-10; MMP-2/9: Matrix metalloproteinases 2/9; TIMP-1: Tissue inhibitor of metalloproteinases-1; CTGF: Connective tissue growth factor; SOD: Superoxide dismutase; PTEN: Phosphatase and tensin homolog; NF-κB: Nuclear factor kappa B; PGE2: Prostaglandin E2; TSG-6: Tumor necrosis factor-alpha-stimulated gene-6; IDO: Indoleamine 2,3-dioxygenase; HLA-G: Human leukocyte antigen G; SDF-1: Stromal cell-derived factor 1; MCP-1: Monocyte chemoattractant protein 1; G-CSF: Granulocyte colony-stimulating factor; ECM: Extracellular matrix; FSTL1: Follistatin-like 1.