Publication Name	World Journal of Stem Cells
Manuscript ID	111978
Country	Saudi Arabia

Category	Cell & Tissue Engineering
Manuscript Type	Meta-Analysis
Article Title	Living bio-drug therapies using mesenchymal stem cells and exosomes for mechanically ventilated patients with acute respiratory distress syndrome: A systematic review and meta-analysis
Manuscript Source	Invited Manuscript
All Author List	Moaz Safwan, Mariam Safwan Bourgleh, Abdulsalam Al-Ruqi, Omran Shrebaty, Faisal Almujaydil, Basel AlOthaim, Nasser AlRashidi and Khawaja Husnain Haider
Funding Agency and Grant Number
Corresponding Author	Khawaja Husnain Haider, PhD, Professor, Department of Basic Sciences, Sulaiman Al Rajhi University, PO Box 777, Al Bukairiyah 51941, AlQaseem, Saudi Arabia. khhaider@gmail.com
Key Words	Acute respiratory distress syndrome; COVID-19; Exosomes; Living bio-drugs; Mesenchymal stem cells; Meta-analysis; Network stem cells
Core Tip	Mesenchymal stem cells, as a living bio-drug, are being considered a potential treatment for coronavirus disease 2019-induced acute respiratory distress syndrome due to their immunomodulatory and reparative properties. Our systematic review and meta-analysis, involving 16 randomized controlled trials (n = 1027 acute respiratory distress syndrome patients), is the first study to directly compare the therapeutic benefits of mesenchymal stem cell-based and their derivative exosome-based therapeutic approaches. Although we did not find significant differences in their safety profiles and efficacy, the exosome-based treatment ranked higher in terms of therapeutic benefits in a network meta-analysis, offering practical and logistical advantages.
Citation	Safwan M, Bourgleh MS, Al-Ruqi A, Shrebaty O, Almujaydil F, AlOthaim B, AlRashidi N, Haider KH. Living bio-drug therapies using mesenchymal stem cells and exosomes for mechanically ventilated patients with acute respiratory distress syndrome: A systematic review and meta-analysis. World J Stem Cells 2025; In press

Received	2025-07-15 09:09
Peer-Review Started	2025-07-16 00:10
To Make the First Decision
Return for Revision	2025-08-19 09:24
Revised	2025-08-28 20:36
Second Decision	2025-10-08 09:57
Accepted by Journal Editor-in-Chief	2025-10-08 22:38
Accepted by Executive Editor-in-Chief	2025-10-13 09:45
Articles in Press	2025-10-13 09:45
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ISSN	1948-0210 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
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