Where Are We Now and Where Is Cell Therapy Headed? (2nd Edition)

A special issue of Pharmaceutics (ISSN 1999-4923). This special issue belongs to the section "Gene and Cell Therapy".

Deadline for manuscript submissions: 15 October 2026 | Viewed by 3920

Editors


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Guest Editor
Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Interests: immunomodulation; mesenchymal stromal cells; cancer biology; regenerative medicine; immunology; perinatal derivatives; secretoma; extracellular vesicles
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Interests: angiogenesis; cancer biology; spheroids; mesenchymal stromal cells; cancer associated fibroblasts; perinatal derivatives
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of cell therapy is at a critical inflection point. While the early promise of using living cells to repair and regenerate tissues has led to remarkable clinical achievements, the scientific community is now embracing a more refined and powerful paradigm. A fundamental shift is taking place: moving from viewing the cell as the sole therapeutic agent to harnessing its biological outputs—such as the secretome and extracellular vesicles (EVs)—as next-generation tools for therapy. This transition from cell transplantation to cell-free and bio-inspired therapeutics offers new opportunities to overcome key challenges in manufacturing, safety, and efficacy.

This Special Issue aims to reflect this exciting evolution by gathering contributions that bridge fundamental biology with innovative clinical translation. We seek to highlight the strategies that are reshaping regenerative medicine and immunotherapy, from the complexity of stem-cell niches to the precision engineering of cellular and cell-derived products.

We welcome original research articles and comprehensive review papers that explore bold and forward-looking concepts in this rapidly advancing field. Our goal is to create a landmark volume that will serve as a valuable resource for scientists and clinicians alike.

Areas of particular interest include, but are not limited to:

  • Investigations into the therapeutic efficacy of mesenchymal stromal cells (MSCs), pluripotent stem cells, and their bioactive derivatives (e.g., secretomes, purified EVs) across diverse disease models.
  • Studies exploring how altered stem-cell niches contribute to pathology, and how advanced therapies can restore tissue homeostasis and function.
  • Innovative platforms for cell and gene therapy in monogenic, degenerative, and malignant diseases, with emphasis on improving safety, control, and therapeutic potency.
  • Design, application, and mechanistic insights into next-generation CAR-T, CAR-NK, and other engineered immune cells for the treatment of hematological and solid tumors.
  • Novel uses of engineered MSCs or other cell types as "smart" delivery vehicles for targeted therapeutic payloads, including drugs, genes, or nanoparticles.

Dr. Andrea Papait
Dr. Paola Chiodelli
Guest Editors

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Keywords

  • stem cells
  • mesenchymal stromal cells
  • cell therapy
  • CAR-T
  • CAR-NK
  • cancer
  • gene therapy
  • organoids and organ on a chip
  • extracellular vesicles
  • secretome

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Published Papers (2 papers)

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Review

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60 pages, 7234 KB  
Review
Cellular Allies Against Glioblastoma: Therapeutic Potential of Macrophages and Mesenchymal Stromal Cells
by Bruno Agustín Cesca, Kali Pellicer San Martin and Luis Exequiel Ibarra
Pharmaceutics 2026, 18(1), 124; https://doi.org/10.3390/pharmaceutics18010124 - 19 Jan 2026
Cited by 3 | Viewed by 1775
Abstract
Background/Objectives: Glioblastoma (GBM) remains the most aggressive primary brain tumor in adults, with limited therapeutic options and poor prognosis despite maximal surgery, radiotherapy, and chemotherapy. The complex and immunosuppressive tumor microenvironment, pronounced intratumoral heterogeneity, and the presence of the blood–brain barrier (BBB) [...] Read more.
Background/Objectives: Glioblastoma (GBM) remains the most aggressive primary brain tumor in adults, with limited therapeutic options and poor prognosis despite maximal surgery, radiotherapy, and chemotherapy. The complex and immunosuppressive tumor microenvironment, pronounced intratumoral heterogeneity, and the presence of the blood–brain barrier (BBB) severely restrict the efficacy of conventional and emerging therapies. In this context, cell-based strategies leveraging macrophages, mesenchymal stromal cells (MSCs), and their derivatives have gained attention as “cellular allies” capable of modulating the GBM microenvironment and acting as targeted delivery platforms. Methods: This review systematically analyzes preclinical and early clinical literature on macrophage- and MSC-based therapeutic strategies in GBM, including engineered cells, extracellular vesicles (EVs), membrane-coated nanoparticles, and hybrid biomimetic systems. Studies were selected based on relevance to GBM biology, delivery across or bypass of the BBB, microenvironmental modulation, and translational potential. Evidence from in vitro models, orthotopic and syngeneic in vivo models, and available clinical trials was critically evaluated, with emphasis on efficacy endpoints, biodistribution, safety, and manufacturing considerations. Results: The reviewed evidence demonstrates that macrophages and MSCs can function as active therapeutic agents or delivery vehicles, enabling localized oncolysis, immune reprogramming, stromal and vascular remodeling, and enhanced delivery of viral, genetic, and nanotherapeutic payloads. EVs and membrane-based biomimetic platforms further extend these capabilities while reducing cellular risks. However, therapeutic efficacy is highly context-dependent, influenced by tumor heterogeneity, BBB integrity, delivery route, and microenvironmental dynamics. Clinical translation remains limited, with most approaches at preclinical or early-phase clinical stages. Conclusions: Cell-based and cell-derived platforms represent a promising but still evolving therapeutic paradigm for GBM. Their successful translation will require rigorous biomarker-driven patient selection, improved models that capture invasive GBM biology, scalable GMP-compliant manufacturing, and rational combination strategies to overcome adaptive resistance mechanisms. Full article
(This article belongs to the Special Issue Where Are We Now and Where Is Cell Therapy Headed? (2nd Edition))
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Other

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21 pages, 1019 KB  
Systematic Review
Mechanistic Insights into the Cardioprotective Effects of Mesenchymal Stem Cell-Derived Exosomes in Myocardial Ischemic Injury: A Systematic Review
by Nur Athirah Othman Basri, Nur Aishah Che Roos, Amilia Aminuddin, Adila A. Hamid, Chua Kien Hui, Mohd Kaisan Mahadi, Jaya Kumar and Azizah Ugusman
Pharmaceutics 2026, 18(3), 346; https://doi.org/10.3390/pharmaceutics18030346 - 11 Mar 2026
Cited by 2 | Viewed by 1627
Abstract
Background: Myocardial ischemic injury, encompassing acute myocardial infarction (MI) and ischemia/reperfusion (I/R) injury, remains a major cause of cardiac morbidity and mortality worldwide, and is driven by interconnected molecular and cellular processes, including cardiomyocyte apoptosis, inflammatory activation, mitochondrial dysfunction, oxidative stress, and impaired [...] Read more.
Background: Myocardial ischemic injury, encompassing acute myocardial infarction (MI) and ischemia/reperfusion (I/R) injury, remains a major cause of cardiac morbidity and mortality worldwide, and is driven by interconnected molecular and cellular processes, including cardiomyocyte apoptosis, inflammatory activation, mitochondrial dysfunction, oxidative stress, and impaired angiogenesis. Mesenchymal stem cell (MSC)-derived exosomes have emerged as a promising cell-free nanotherapeutic strategy for cardiac repair due to their ability to transfer bioactive molecules that modulate multiple signaling networks involved in myocardial survival and regeneration. This systematic review aimed to synthesize evidence on the mechanistic basis of MSC-derived exosome mediated cardioprotection in myocardial ischemic injury. Methods: A systematic search of Ovid MEDLINE, Scopus, and Web of Science was conducted to identify studies investigating the effects of MSC-derived exosomes on myocardial ischemic injury. Eligible studies included clinical and preclinical models of MI or I/R injury assessing functional, biochemical, and molecular outcomes. Results: Seven preclinical studies published between 2015 and 2025 met the inclusion criteria. Exosome administration consistently improved cardiac function, reduced infarct size, and preserved myocardial architecture. Biochemical analyses revealed decreased cardiac injury markers, alongside suppressed apoptosis, inflammation, and oxidative stress. Mechanistically, MSC-derived exosomes delivered regulatory miRNAs (e.g., miR-19a, miR-125b, miR-205, miR-294) and lncRNAs (HAND2-AS1) that modulated key signaling pathways including PI3K/Akt, JAK2/STAT3, HAND2-AS1/miR-17-5p/Mfn2, and HIF-1α/VEGF. These molecular effects collectively inhibited apoptotic and inflammatory responses, enhanced mitochondrial integrity, and promoted angiogenesis and myocardial repair. Conclusions: MSC-derived exosomes confer robust cardioprotection against myocardial ischemic injury through integrated anti-apoptotic, anti-inflammatory, antioxidant, and pro-angiogenic mechanisms. Their multifaceted bioactivity, low immunogenicity, and potential for targeted delivery highlight their potential as a next-generation nanomedicine for ischemic heart disease. Future studies should emphasize standardized exosome production, mechanistic profiling, and translational validation in large-animal and clinical models. Full article
(This article belongs to the Special Issue Where Are We Now and Where Is Cell Therapy Headed? (2nd Edition))
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