Karunamurthy, Prarthna2026-01-232026-01-232026-01-23http://hdl.handle.net/10393/51306https://doi.org/10.20381/ruor-31700Acute Respiratory Distress Syndrome (ARDS) remains a major cause of morbidity and mortality. Despite significant advances in critical care, therapeutic options are largely limited to supportive care strategies. Regulatory T cells (Tregs) and their extracellular vesicles (Treg-EVs) have emerged as promising immunomodulatory treatments, yet their application in ARDS remains critically limited. This thesis addresses this issue through three complementary aims: (1) identifying existing knowledge gaps using a systematic review of preclinical and clinical evidence on Treg-based therapies for acute lung injury (ALI, the preclinical counterpart of ARDS); (2) establishing and characterizing a clinically relevant, translationally validated viral ALI model; and (3) evaluating the safety and preliminary therapeutic efficacy of Treg-EVs for ALI in vivo. Together, these studies offer foundational mechanistic and translational insights, advancing the understanding of Treg-based therapies.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Acute Respiratory Distress SyndromeAcute Lung InjuryRegulatory T-cellsRegulatory T-cell Extracellular VesiclesTreg TherapyExtracellular VesiclesCell TherapyThesis