Advances and mechanisms in the application and treatment of functionalized stem cells and their derivatives in allergic rhinitis.

Allergic rhinitis (AR) is characterized by Th2/Th17/Treg immune imbalance and nasal mucosal barrier damage, and current treatments struggle to restore immune homeostasis. Mesenchymal stem cells (MSCs) and their exosomes can exert anti-inflammatory and barrier-repairing effects through paracrine pathways, but natural MSCs have poor targeting and short local retention, limiting their efficacy. Recent functionalization and novel delivery systems have significantly enhanced their efficacy, and combination therapy strategies have shown synergistic potential. However, current evidence is largely derived from animal models, clinical studies lack large-scale, long-term data, and standardization of MSCs from different sources and engineered products is insufficient. Future research should leverage multi-omics and intelligent design to advance personalized treatment plans, providing a new direction for non-hormonal "immune reset" therapy for AR. This review systematically summarizes the mechanisms, strategies, and translational bottlenecks of functionalized stem cell derivatives in AR, providing a theoretical framework for subsequent precision cell therapy research.