Modified mesenchymal stem cells as an innovative therapeutic approach in systemic lupus erythematosus: A comprehensive review.

Systemic lupus erythematosus (SLE) is a complex autoimmune disorder of unknown etiology that is influenced by environmental and genetic factors. The disease is associated with severe clinical manifestations, including renal involvement, skin, nervous system, and cardiovascular system complications. Given the severity of these symptoms, there is a need for effective treatments with minimal side effects. Current treatments, such as corticosteroids, result in significant adverse outcomes and show limited efficacy. As a result, new therapeutic approaches are being investigated. Among these, cell-based therapies, especially stem cell therapy, have attracted attention due to the immunomodulatory and regenerative properties of stem cells. However, several challenges limit the clinical success of mesenchymal stem cell (MSC) therapies. These challenges include lack of targeted transduction, limited survival and proliferation of transplanted cells, and difficulties in maintaining therapeutic properties and function. To overcome these limitations and improve efficacy, strategies for modifying MSCs have been developed, such as genetic engineering via gene therapy, nanotechnology-based drug delivery systems to enhance targeting and homing, and pretreatment of MSCs with anti-inflammatory agents or compounds that enhance survival and migration. This review explores strategies for modifying MSCs to enhance their therapeutic potential in the treatment of systemic lupus erythematosus.