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. 2024 May 7;15:136. doi: 10.1186/s13287-024-03737-w

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 3 — The role of stem cell-based therapies in the treatment of AD. A Through direct transplantation, retransplantation following differentiation into neural cells, and secretory exosome infusion, stem cells offer various benefits for treating AD. B Stem cells with their differentiated cells and derived exosomes regulate the release of a range of cytokines, reducing levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and increasing levels of anti-inflammatory cytokines (IL-1 receptor antagonist (IL-1ra), IL-10) in cerebrospinal fluid. C The phenotypes of microglia and astrocytes are changed by stem cells through their differentiated cells and exosomes, shifting them from a pro-inflammatory to anti-inflammatory phenotype and decreasing the inflammatory response in the brain and promoting neuroactivity. D Stem cells with their differentiated cells and derived exosomes are upregulated with Brain-Derived Neurotrophic Factor (BDNF), Nerve Growth Factor (NGF), etc. The stem cells transplanted through exogenous pathways are integrated into the neural network to regenerate synapses. E As MSCs with their differentiated cells and exosomes activate microglia, they specifically phagocytose Aβ or regulate the expression levels of Aβ-related enzymes (e.g., upregulate α-secretase activity or downregulate β-secretase activity) to clear existing Aβ deposits