Figure 2.

SC-Exo miRNA cargo regulates dysregulated pathways in ARDS. NF-κB is one of the main pathways in which out of balance activity in ARDS leads to lung damage. NF-κB upregulation during ARDS leads to an increased level of proinflammatory factors and sonic hedgehog (Shh) protein, which triggers the hedgehog signaling pathway and begins epithelial–mesenchymal transition in alveolar-epithelial cells. SC-Exos can restore balance to the NF-κB pathway activity and prevent inflammation and EMT, mediated by several miRNAs targeting different proteins upstream of the NF-κB, including TLR4 and IKKβ. FZD6 is another target of SC-Exo miRNA, and its suppression can lead to NF-κB downregulation; however, it is mainly associated with the Wnt/β-Catenin pathway, and the underlying relation between FZD6 and NF-κB is not fully determined.