EVs extracted from adipose-derived MSCs (ADSC) attenuate myocardial injury, myocardial apoptosis, myocardial fibrosis, and inflammatory response after MI by promoting macrophage M2 polarization through activating sphingosine-1-phosphate/sphingosine kinase 1/sphingosine-1-phosphate receptor 1 (S1P/SK1/S1PR1) signaling pathway [60]. This evidence concerns the gene S1PR1 and Myocardial fibrosis.