Exploring mesenchymal stem cells as a novel therapeutic approach for HACEK endocarditis: a narrative review

Extensive research has investigated the therapeutic potential of mesenchymal stem cells (MSCs) in treating infectious diseases and mitigating tissue damage caused by these diseases. MSCs, along with their exosomes, present a promising avenue for combating infectious diseases, particularly HACEK endocarditis (HE). MSCs possess immunomodulatory properties and aid in tissue repair, while exosomes carry bioactive molecules. Antimicrobial peptides (AMPs) released by MSCs demonstrate efficacy against a broad spectrum of microorganisms, including bacteria, fungi, yeasts, and viruses. Key AMPs produced by MSCs include hepcidin, cathelicidin LL-37, and β-defensin-2. Furthermore, these AMPs have been found to interact with MSCs, influencing their proliferation, migration, and regeneration, indicating a broader biological impact than previously recognized. Preclinical studies have highlighted the potential of these AMPs to reduce inflammation, enhance cardiac function, and augment the efficacy of antibiotics against bacterial pathogens. This narrative review investigates the antimicrobial efficacy of MSCs, with specific emphasis on their therapeutic application against HACEK-associated infective endocarditis.