From:  Immuno-materials: exploring the translational aspects among immunology, biomaterials and biomedicine

 Comparative analysis of MSCs vs. MSC-derived EVs in immunomodulation.

FeatureMesenchymal stem cells (MSCs)MSC-derived EVs/exosomesKey reference
NatureLiving, cellular therapy; metabolically active.Acellular, membrane-bound vesicles (paracrine mediators).[51]
MechanismDynamic sensing; adapts response to microenvironmental cues via cell-cell contact and paracrine signaling.Targeted delivery of pre-defined bioactive cargo (miRNA, proteins, lipids).[52]
Safety profilePotential risks of maldifferentiation, lung trapping (IV), or inflammatory activation.Minimal immunogenicity; no risk of tumorigenesis or self-replication.[53]
StabilityRequires cryopreservation; sensitive to handling and transport logistics.High stability; amenable to lyophilization and easier “off-the-shelf” distribution.[52]
Biological barriersLimited by cell size; often sequestered in the lungs after systemic administration.Small size (30–150 nm) allows better penetration of biological barriers (e.g., BBB).[54]
Regulatory pathComplex; requires rigorous characterization of living cell batches.Emerging as biologic products, potentially easier standardization and scale-up.[55]
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EVs: extracellular vesicles; BBB: blood-brain barrier.