Immunomodulatory Effects of Mesenchymal Stromal Cells Revisited in the Context of Inflammatory Cardiomyopathy

Figure 2

Hypothetical scheme representing how the cardiac outcome in inflammatory cardiomyopathy may be influenced after i.v. injection of MSCs or the MSC-like CardAPs. Via (a) direct cardioprotective effects, via (b) extracardiac immunomodulatory effects involving MSCs/CardAPs-mediated immunomodulation in the spleen and/or other secondary lymphoid organs, and the induction of tumor necrosis factor-stimulated gene- (TSG-) 6 expression by human MSCs/CardAPs upon engraftment, for example, in the lung, and via (c) systemic endothelial-protective effects. The contribution of (a), (b), or (c) on the final cardiac outcome is expected to depend on the kind of inflammatory cardiomyopathy, be it viral- (CVB3 or B19-induced) or nonviral- induced.