RT Journal Article T1 Heterogeneity of In Vitro Expanded Mesenchymal Stromal Cells and Strategies to Improve Their Therapeutic Actions. A1 Olmedo-Moreno, Laura A1 Aguilera, Yolanda A1 Baliña-Sánchez, Carmen A1 Martín-Montalvo, Alejandro A1 Capilla-González, Vivian K1 cell engineering K1 cell therapy K1 drug delivery K1 induced pluripotent stem cells K1 mesenchymal stem cells K1 preconditioning K1 regenerative medicine K1 scaffolds K1 secretome AB Beneficial properties of mesenchymal stromal cells (MSCs) have prompted their use in preclinical and clinical research. Accumulating evidence has been provided for the therapeutic effects of MSCs in several pathologies, including neurodegenerative diseases, myocardial infarction, skin problems, liver disorders and cancer, among others. Although MSCs are found in multiple tissues, the number of MSCs is low, making in vitro expansion a required step before MSC application. However, culture-expanded MSCs exhibit notable differences in terms of cell morphology, physiology and function, which decisively contribute to MSC heterogeneity. The changes induced in MSCs during in vitro expansion may account for the variability in the results obtained in different MSC-based therapy studies, including those using MSCs as living drug delivery systems. This review dissects the different changes that occur in culture-expanded MSCs and how these modifications alter their therapeutic properties after transplantation. Furthermore, we discuss the current strategies developed to improve the beneficial effects of MSCs for successful clinical implementation, as well as potential therapeutic alternatives. SN 1999-4923 YR 2022 FD 2022-05-23 LK http://hdl.handle.net/10668/21550 UL http://hdl.handle.net/10668/21550 LA en DS RISalud RD Apr 7, 2025