A narrative review of stem cell-based therapy for fibrosing interstitial lung diseases: clinical evidence and translational perspectives

Fibrosing interstitial lung diseases (F-ILD) are a heterogeneous group of disorders characterized by pulmonary interstitial fibrosis and inflammation. Idiopathic pulmonary fibrosis (IPF) is the most common and severe form of F-ILD. Regulator-approved anti-fibrotic drugs, such as pirfenidone and nintedanib, delay rather than reverse disease progression, so the threat of eventual respiratory failure remains. While lung transplantation is an option that can prolong survival for end-stage IPF, its clinical application is greatly restricted by donor shortages, surgical risks, and postoperative complications. Stem cell therapies, and particularly treatments based on mesenchymal stromal/stem cells (MSCs) and their derivatives, have brought new hope for the management of F-ILD due to their immune regulatory, anti-inflammatory, and anti-fibrotic capabilities. A search was conducted to identify relevant articles in the PubMed/MEDLINE, Web of Science, Cochrane Library, China National Knowledge Internet and Wanfang Data from inception to 31st May 2026. This review summarizes the mechanistic overview of stem cell-based therapeutic strategies for F-ILD, safety profiles and therapeutic potentials of various stem cells for the treatment of IPF and other F-ILDs, with an emphasis on stem cell types and delivery routine. This article also discusses the challenges and limitations of stem cell-based therapies, highlighting the need for further clinical studies with standardized efficacy endpoints to validate their effectiveness.