{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:05:36Z","timestamp":1784531136420,"version":"3.55.0"},"reference-count":87,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":199,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Stem Cells International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Human papillomavirus (HPV) infection is the most common sexually transmitted viral infection, strongly associated with chronic inflammation and cervical cancer progression in women. Persistent HPV infection leads to an inflammatory microenvironment that promotes epithelial dysplasia and immune evasion. Exosomes derived from mesenchymal stem cells (MSC\u2010exosomes) have emerged as promising immunomodulatory and anti\u2010inflammatory agents. This review examines current evidence on the interaction between HPV\u2010induced inflammation and exosomal signaling, with a particular focus on the therapeutic potential of MSC\u2010exosomes. We discuss their roles in immune regulation, miRNA delivery, suppression of nuclear factor kappa\u2010light\u2010chain\u2010enhancer of activated B cells (NF\u2010\u03baB) signaling, and epithelial regeneration. This anti\u2010inflammatory effect may also impair local immune surveillance, potentially enabling viral persistence and progression to malignancy. In this narrative review, We reviewed PubMed, Scopus, and Web of Science articles published up to 2024 on MSC\u2010exosome interactions with immune regulation in HPV\u2010related diseases. Evidence suggests that while the anti\u2010inflammatory effects of MSC\u2010exosomes may help control HPV\u2010associated inflammation, they can also impair local immune surveillance, potentially facilitating viral persistence and progression toward malignancy. This dual activity positions MSC\u2010exosomes as a double\u2010edged sword in the context of HPV pathogenesis. A deeper understanding of this paradox is essential for designing safer, context\u2010specific MSC\u2010based therapies that balance anti\u2010inflammatory benefits with effective antiviral immune responses. Although direct studies on MSC\u2010exosomes in HPV infections are limited, existing models suggest that they have the capacity to attenuate inflammation and restore cervical tissue homeostasis. This article also highlights knowledge gaps and future research directions necessary to develop MSC\u2010exosome\u2010based therapies for HPV\u2010related cervical diseases.<\/jats:p>","DOI":"10.1155\/sci\/2596453","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:37:27Z","timestamp":1784529447000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mesenchymal Stem Cell\u2010Derived Exosomes as a Double\u2010Edged Sword: Balancing Inflammation and Immunosuppression in Human Papillomavirus\u2010Infected Tissues"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8261-2251","authenticated-orcid":false,"given":"Fatemeh","family":"Poorhoseini 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