MSC-EVs also produce promising therapeutic outcomes in ALI/ARDS by inhibiting the proliferation and differentiation of B-cells as well as promoting the differentiation of TH-cells to Treg cells, leading to the down-regulation of pro-inflammatory cytokines TNF-α, IL-1β, and IFN-γ and up-regulation of anti-inflammatory cytokines PEG2, IL-10, and TGF-β [196]. This evidence concerns the gene TGFB1 and acute respiratory distress syndrome.