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Mesenchymal stromal cells (MSCs) have garnered significant interest as a potential treatment for cerebral ischemic damage, as shown in ischemic stroke, because of their potent intrinsic features, which include self\u2010regeneration, immunomodulation, and multi\u2010potency. Additionally, MSCs are easily obtained, isolated, and cultured. Despite this, there are a number of obstacles that hinder the effectiveness of MSC\u2010based treatment, such as adverse microenvironmental conditions both in vivo and in vitro. To overcome these obstacles, the na\u00efve MSC has undergone a number of modification processes to enhance its innate therapeutic qualities. Genetic modification and preconditioning modification (with medications, growth factors, and other substances) are the two main categories into which these modification techniques can be separated. This field has advanced significantly and is still attracting attention and innovation. We examine these cutting\u2010edge methods for preserving and even improving the natural biological functions and therapeutic potential of MSCs in relation to adhesion, migration, homing to the target site, survival, and delayed premature senescence. We address the use of genetically altered MSC in stroke\u2010induced damage. Future strategies for improving the therapeutic result and addressing the difficulties associated with MSC modification are also discussed.<\/jats:p>","DOI":"10.1002\/cbf.3957","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:30:03Z","timestamp":1710203403000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Therapeutic gene delivery by mesenchymal stem cell for brain ischemia damage: Focus on molecular mechanisms in ischemic stroke"],"prefix":"10.1002","volume":"42","author":[{"given":"Raed Obaid","family":"Saleh","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Techniques Al\u2010Maarif University College Al\u2010Anbar Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali A.","family":"Majeed","sequence":"additional","affiliation":[{"name":"Department of Pathological Analyses, Faculty of Science University of Kufa Najaf 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