Mesenchymal Stem/Stromal Cells and Their Derived Extracellular Vesicles: a Promising Therapeutic Strategy for Autoimmune Hepatitis.

Autoimmune hepatitis (AIH) is an idiopathic autoimmune disorder characterized by chronic liver inflammation that, if untreated, can lead to liver fibrosis and cirrhosis, hepatic failure, and death. Current treatment options for this potentially life-threatening disorder include either high-dose immunosuppressants or liver transplantation (for late-stage patients). However, these options are risky and can lead to long-term complications. Therefore, there is an urgent need to develop novel treatment strategies for AIH. Therapeutic approaches based on mesenchymal stem/stromal cells (MSCs) and their derived extracellular vesicles (EVs) have emerged as a viable treatment option for AIH because of their potent immunomodulatory and anti-inflammatory properties. This review outlines the recent developments in the use of these therapies for the treatment of AIH. The use of EVs as vehicles for the delivery of therapeutic drugs or miRNAs is also discussed. In addition, we discuss the various efforts that have been made to improve the efficacy of such therapies, including their genetic modification and combination with anti-inflammatory drugs. Finally, we proposed several directions for future research aimed at developing MSCs and MSC-derived EVs for clinical applications.