 Mesenchymal stem cells, MSCs, are a valuable cell type used in clinical practice as therapeutic agents for immunomodulation and ischemic tissue repair due to their multiple differentiation potential, strong paracrine capacity, mitochondrial transfer, and microvesicle secretion. However, challenges remain before widespread clinical application, including the need to explore and understand the in-death paracrine mechanisms of MSCs. This article was authored by Xiao Tingliang, Yu Ding, Yu-Ellen Zhang, and others.