Abstract / Summary
Pulmonary fibrosis (PF) represents a heterogeneous group of chronic fibrotic lung diseases, characterized by excessive extracellular matrix (ECM) deposition and irreversible scarring, lacking curative therapies. This review highlights the antifibrotic efficacy of adipose-derived mesenchymal stem cells (AD-MSCs) in pre-clinical PF models. The review was prospectively registered in the PROSPERO database (registration number: CRD420251119193). Peer-reviewed experimental investigations/original articles were searched from Google Scholar, PubMed, and ScienceDirect up to April 2025. Risk of bias in in-vivo studies was assessed using SYRCLE's tool and for in-vitro studies, quality was evaluated with the QUIN tool. Results were synthesized narratively and quantitatively, using a random-effects model to pool mean differences (MD) with 95% confidence intervals for antifibrotic outcomes based on Ashcroft scores. Heterogeneity was assessed using Cochran's Q test and I2 statistic. A comprehensive literature search yielded 397 studies, out of which 19 studies selected after title-based, abstract-based, and full text-based screening. Forest plot showed overall mean difference as -1.35 [95% CI: -3.19, 0.49]. Ashcroft scores were lower in treated groups compared with control group, but overall mean difference was not statistically significant (z = 1.44, p = 0.15), likely due to small number of studies included and high heterogeneity. However, individual studies demonstrated reduced fibrosis in treated groups. AD-MSCs consistently reduced fibrosis in pre-clinical PF models while modulating pathways relevant to IPF pathogenesis i.e., Smad, NF-κB, ERK, and key miRNA networks. Collectively, current evidences position AD-MSCs and their derivatives as promising antifibrotic candidates with strong clinical translation potential.
Primary Source
European journal of pharmacology
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