• Overexpression of miR181-a in BMSCs enhances their immunomodulatory effects, promoting Bregs and Tregs proliferation while inhibiting Th17 cells.
• The synergistic therapy prolongs the modulatory effects of BMSCs and increases exosomal miRNA concentration by 10-fold, extending miRNA biological activity.
• This approach significantly attenuates experimental autoimmune encephalomyelitis (EAE), a model for multiple sclerosis, showing consistent therapeutic benefits.
• The combination strategy offers a promising novel therapeutic avenue for MS by targeting immune balance and leveraging stem cell homing capabilities.