Figure 3. |. The systemic therapeutic effects of intravenousMSC therapy in SA-AKI are triggered by immune cell interactions in the lungs.

As illustrated, intravenous administration of MSCs in the setting of SA-AKI results in MSC trapping in the lungs, where complex interactions (crosstalk and efferocytosis) with resident immune cells (mononuclear phagocytes [macrophages] and lymphocytes) result in beneficial localized effects within the alveolar spaces and systemic effects (LPS neutralization, secretion of anti-inflammatory factors, enhanced phagocytosis) with potential to promote resolution of inflammation, disrupted vascular integrity, and increased cell death in the kidneys. Improved cardiorespiratory function as a result of MSC local and systemic effects may provide further indirect effects to more effectively resolve SA-AKI. Figure created using Biorender.com. HGF, hepatocyte growth factor; KGF, keratinocyte growth factor.