L-arginine: A promising metabolite in enhancing the protective effects of adipose-derived stem cells against ischemic pathologies.

Bone marrow-derived mesenchymal stem cells (BMSCs) and adipose tissue-derived mesenchymal stem cells (ADSCs), two principal subtypes of mesenchymal stem cells with multilineage regenerative potential, have emerged as promising therapeutic strategies for various diseases. While BMSCs and ADSCs exhibit distinct functional profiles tailored to different therapeutic applications, emerging evidence suggests that ADSCs may be a more promising approach for treating ischemic pathologies, including myocardial infarction, ischemic stroke, and peripheral artery disease, in comparison with BMSCs. However, the precise molecular mechanisms by which ADSCs enhance the therapeutic outcomes in these diseases remain poorly understood. In this editorial, we comment on the article by Li , which systematically compares the therapeutic efficacy of ADSCs and BMSCs derived from the same elderly patients with coronary heart disease and explores the underlying mechanism from a metabolic perspective. This study proposes that the metabolite L-arginine in ADSCs isolated from elderly patients promotes angiogenesis and protects against apoptosis in a hypoxic and ischemic microenvironment, thereby enhancing myocardial repair following infarction. These findings not only highlight the metabolic plasticity of ADSCs but also position L-arginine as a pivotal therapeutic effector in coronary heart disease. Given the novel and crucial role of L-arginine in ischemic heart diseases, further exploration of L-arginine in ADSCs (particularly those derived from elderly individuals) is essential, including its roles in angiogenesis, cell death, and the potential therapeutic implications in other ischemic pathologies. Additionally, further investigation into additional metabolites in ADSCs is warranted to enhance the therapeutic potential of ADSCs in ischemic pathologies.