Umbrella review of mesenchymal stem cell-derived extracellular vesicles in preclinical models: therapeutic efficacy across diverse conditions.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) have emerged as a promising cell-free therapeutic strategy for various diseases due to their anti-inflammatory, anti-apoptotic, and regenerative properties. Numerous meta-analyses have evaluated MSC-EV efficacy in preclinical animal models, but a comprehensive synthesis across diverse conditions is lacking. Objective This umbrella review aims to systematically evaluate the therapeutic efficacy, mechanisms, and methodological quality of MSC-EVs in preclinical models across multiple diseases. Methods A systematic search of Scopus and Web of Science was conducted to identify meta-analyses published up to July 2025, focusing on MSC-EV interventions in preclinical animal models. Data were extracted on study characteristics, exosome sources, animal models, outcomes, and risk of bias. The AMSTAR 2 tool assessed meta-analysis quality, while SYRCLE and CAMARADES tools evaluated primary study bias. Narrative and quantitative syntheses summarized efficacy, heterogeneity, and publication bias. Results Forty-seven meta-analyses covering 27 diseases were included, spanning neurological, renal, wound healing, liver, musculoskeletal, respiratory, and reproductive disorders. MSC-EVs demonstrated high efficacy, significantly improving functional scores, reducing inflammation, and promoting regeneration. Bone marrow-, adipo

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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