en Stem Cell Stem Cell Review Review <p style="text-align: justify;"><span style="font-size:12px;"><span style="font-family:Tahoma;"><span style="line-height:150%"><span style="line-height:150%">Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) are a promising cell-free therapeutic in preclinical models of tendon healing. However, clinical translation remains to be demonstrated. MSC-EVs modulate two critical and interlinked processes in tendon repair inflammation and angiogenesis primarily via delivery of bioactive cargo such as microRNAs and proteins. In inflammation, MSC-EVs promote the transition of macrophages from a pro-inflammatory (M1) to an anti-inflammatory (M2) phenotype, enhancing the resolution of inflammation. In angiogenesis, MSC-EVs facilitate endothelial cell proliferation and migration, promoting early vascularization followed by vascular regression during later healing. Recent advancements in MSC-EVs engineering and delivery systems have improved their therapeutic efficacy, yet further research is essential to elucidate their molecular mechanisms and achieve precise therapeutic outcomes.</span></span></span></span></p> Angiogenesis, Extracellular vesicles, Inflammation, Mesenchymal stem cells, Tendon regeneration 0 0 http://ijmcmed.org/browse.php?a_code=A-10-8474-1&slc_lang=en&sid=1 Daffa Raditya Fernanda daffa.raditya03@ui.ac.id 100319475328460036845 0009-0000-5954-0210 No Department of Biology, Faculty Mathematics and Natural Sciences, Universitas Indonesia Radiana Dhewayani Antarianto radiyana.dhewayani@ui.ac.id 100319475328460036846 100319475328460036846 No Department of Histology, Faculty of Medicine, Universitas Indonesia Abinawanto Abinawanto abinawanto.ms@sci.ui.ac.id 100319475328460036847 100319475328460036847 No Department of Biology, Faculty Mathematics and Natural Sciences, Universitas Indonesia Retno Lestari retno.lestari@sci.ui.ac.id 100319475328460036848 100319475328460036848 Yes Department of Biology, Faculty Mathematics and Natural Sciences, Universitas Indonesia