Mechanistic convergence of exercise and mesenchymal stem cell-derived exosome signaling in isoproterenol-induced myocardial injury

Figure 1 Ultrasound-enabled delivery platforms for myocardial repair signaling (schematic). Schematic comparison of: (1) Targeted nanobubbles carrying adipose-derived mesenchymal stem cell exosomes enriched for SDF-1α via anti-CD81 tethering and cRGD targeting, with LIPUS used to increase myocardial localization and exosome availability; (2) Cationic microbubbles carrying SDF1 and shFOXO4 plasmids delivered by ultrasound-targeted microbubble destruction; (3-6): Enabling cellular entry (3) and transcription (4), with SDF-1α secretion supporting chemotactic homing (5) and ShFOXO4 driving FOXO4 knockdown to promote senescent-cell clearance (6); and (7) Phase-change nanoparticles delivering miR-125b to support post-transcriptional silencing and reduced intrinsic apoptosis signaling. This figure is a conceptual synthesis and is not intended to imply that every intermediate node shown was directly measured in each cited study. This figure was created by BioRender.com (Supplementary material). LIPUS: Low-intensity pulsed ultrasound; UTMD: Ultrasound-targeted microbubble destruction; SDF-1α: Stromal cell-derived factor-1α; AD-MSC: Adipose-derived mesenchymal stem cell; ROS: Reactive oxygen species; MOMP: Mitochondrial outer membrane permeabilization.