Tehran University of Medical Sciences Journal of Medical Bacteriology 2251-8649 13 3 2025 08 30 146 168 Behnam Poureslamfar Department of Biology, Faculty of Science, Yasouj University, Yasouj, Iran Sahar Yadegari Supervisor, Clinical Diagnostic Laboratories, Erfan Hospital Kanzur Rahman Mufazzil Department Medicine, School of Medicine, Tehran University of Medical Sciences ,Tehran,Iran. Mahmood Karimi Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord , Iran Behnaz Misaii Department of Cell and Molecular Biology, Faculty of Chemistry, University of Kashan, Kashan, Iran Faezeh Tehrani Niya M.Sc. in Microbial Biotechnology, Department of Biotechnology, Azad University of Urmia, Urmia, Iran Reza Yekani Department of Biochemistry and Biophysics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran. Forouzan Esmaeili Dahaj Stem Cell Biology Research Center, Yazd Reproductive Science Institute ,Shahid Sadoughi University of Medical Sciences, Yazd, Iran Ali Abesi Student Research Committee, school of medicine,Isfahan University of Medical Sciences, Isfahan, Iran Mona Mohammadzadeh Department of Biochemistry, faculty of biological sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran 2025 07 06 2025 07 28 Burn injuries present a considerable global health challenge, characterised by intricate healing processes that are exacerbated by infection and impaired tissue regeneration. Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic option due to their regenerative, immunomodulatory, and antimicrobial properties. MSCs have been shown to secrete AMPs such as LL-37 and hepcidin, which have been found to directly target pathogens including Pseudomonas aeruginosa and Staphylococcus aureus. In addition to this direct antimicrobial action, MSCs have also been observed to modulate immune responses through the secretion of cytokines such as IL-10 and TGF-β. Their regenerative effects include the promotion of angiogenesis, re-epithelialization, and extracellular matrix (ECM) remodelling via growth factors such as EGF, KGF, and SDF-1. In-vitro and animal studies have demonstrated enhanced wound closure, reduced scarring, and improved antimicrobial efficacy through novel delivery systems such as hydrogels and preconditioning strategies. As demonstrated by clinical trials, the treatment has been shown to facilitate accelerated healing and reduced reliance on antibiotics. However, challenges such as the heterogeneity of mesenchymal stem cells (MSCs), optimisation of dosing, and safety concerns (e.g. coagulopathy, systemic inflammation) persist. Emerging technologies, including synthetic gene circuits, microbiome-targeted engineering, and bioresponsive delivery systems, offer solutions to enhance the efficacy of MSCs. This review emphasises the potential of MSCs to transform the management of burn wounds, while underscoring the necessity for standardised protocols and advanced engineering to surmount translational barriers. https://jmb.tums.ac.ir/index.php/jmb/article/view/590