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The mechanisms of MSC therapy in ARDS. The therapeutic effects of MSCs in ARDS involve multiple mechanisms via their secretion of soluble paracrine protein factors and extracellular vesicles (EVs). MSCs can exert anti-inflammatory, anti-apoptotic, and anti-microbial effects, protect the pulmonary endothelial and alveolar epithelial cells, enhance alveolar fluid clearance, and inhibit lung fibrosis
