Some studies of autoimmune diseases have reported that MSC-EVs drive a shift from Th1 toward Th2 cells and rebalances Th1/Th2 cells by downregulating proinflammatory cytokines TNFα and IFNγ and upregulating anti-inflammatory cytokines IL-10 or IL-4 [36, 50]. Here, IL4 is linked to autoimmune disease.