Figure 1.

Role of MSC-EVs in the modulation of SSc. In the stage of vasculopathy in SSc, endothelial cells are activated and even destroyed. Vascular smooth muscle cells and pericytes proliferate abnormally. A large number of immune cells also participate in the process of SSc. Likewise, there are large numbers of α-SMA-positive myofibroblasts, which produce excessive amounts of extracellular matrix (ECM), in particular Collagen I and III, resulting in fibrosis. MSC-EVs promote angiogenesis by regulating vasoactive factors and signaling pathways and carrying miRNA. MiRNA/key factors and signaling pathways are involved in the modulation of inflammation and fibrosis by MSC-EVs. Text in blue indicates mechanisms involved in SSc. MSC-EVs, mesenchymal stem cell-derived extracellular vesicles; SSc, systemic sclerosis.