Fig. 6

Illustration of possible mechanisms that HMGB1 modification improves the efficacy of mesenchymal stem cells (MSCs) in treating the radiation-induced vascular injury. HMGB1-modified MSCs (MSC-H cells) produce and actively release HMGB1 to the extracellular milieu. Extracellular HMGB1 binds to and signals via its receptors on MSC-H cells which are activated to generate more HMGB1 via a positive feedback loop. Besides, extracellular HMGB1 primes MSCs to increase their mobility and differentiation toward endothelial lineage. Multiple pathways are involved in the process, including the SDF-1/CXCR4 axis, MAPK, and p53 signaling. Thus, the ability of MSCs to regenerate is improved and later translated to their high efficacy in inhibiting neointima formation after irradiation