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In this work, a pooled analysis was conducted to explore the overall effect of MSC-EV in animal models. Methods: A systematic search of the PubMed, EMBASE, Web of Science, and Cochrane Library databases was performed, from initiation to February 2022, for preclinical studies with liver disease models. The treatment outcomes were evaluated based on liver function, histological analysis, and inflammatory cytokines. Results: After screening, 39 studies were included. Pooled analyses demonstrated that MSC-EV therapy significantly improved liver functions (ALB, ALT, AST, ALP, and \u03b3-GT), promoted the repair of injured liver tissue (damaged area, Ishak\u2019s score), reduced inflammatory factors (TNF-\u03b1, IL-1\u03b2, IL-6, and IFN-\u03b3), and increased an anti-inflammatory cytokine (IL-10) compared to the placebo control group. Subgroup analyses indicated that MSC-EV had therapeutic effects on liver fibrosis (n = 16), acute liver injury (n = 11), non-alcoholic fatty liver disease (n = 3), autoimmune hepatitis (n = 4), and hepatic ischemia-reperfusion injury (n = 6). Additionally, the therapeutic effect of EV was comparable to that of MSCs. Conclusion: MSC-EV have therapeutic potential for acute and chronic liver diseases.<\/jats:p>","DOI":"10.3390\/jpm13030441","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T02:28:17Z","timestamp":1677637697000},"page":"441","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Pooled Analysis of Mesenchymal Stromal Cell-Derived Extracellular Vesicle Therapy for Liver Disease in Preclinical Models"],"prefix":"10.3390","volume":"13","author":[{"given":"Xinru","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Zhoushan Hospital, Zhejiang University School of Medicine, Zhoushan 316021, China"},{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"},{"name":"Department of Laboratory Medicine, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feiqiong","family":"Gao","sequence":"additional","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qigu","family":"Yao","sequence":"additional","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoying","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Zhoushan Hospital, Zhejiang University School of Medicine, Zhoushan 316021, China"},{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"},{"name":"Department of Laboratory Medicine, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiong","family":"Yu","sequence":"additional","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-6867","authenticated-orcid":false,"given":"Hongcui","family":"Cao","sequence":"additional","affiliation":[{"name":"State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China"},{"name":"Jinan Microecological Biomedicine Shandong Laboratory, Jinan 250117, China"},{"name":"Key Laboratory of Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases of Zhejiang Province, 79 Qingchun Rd, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shibo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Zhoushan Hospital, Zhejiang University School of Medicine, Zhoushan 316021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1186\/s12916-014-0159-5","article-title":"The global burden of liver disease: A challenge for methods and for public health","volume":"12","author":"Byass","year":"2014","journal-title":"BMC Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Mokdad, A.A., Lopez, A.D., Shahraz, S., Lozano, R., Stanaway, J., Murray, C.J., and Naghavi, M. 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