Mesenchymal stromal cells (MSCs) can generate immunological tolerance due to their regulatory activity in many immune cells. Extracellular vesicles (EVs) release is a pivotal mechanism by which MSCs exert their actions. In this study, we evaluate whether mesenchymal stromal cell extracellular vesicles (MSC-EVs) can modulate T cell response. MSCs were expanded and EVs were obtained by differential ultracentrifugation of the supernatant. The incorporation of MSC-EVs by T cells was detected by confocal microscopy. Expression of surface markers was detected by flow cytometry or CytoFLEX and cytokines were detected by RT-PCR, FACS and confocal microscopy and a miRNA PCR array was performed. We demonstrated that MSC-EVs were incorporated by lymphocytes in vitro and decreased T cell proliferation and Th1 differentiation. Interestingly, in Th1 polarization, MSC-EVs increased Foxp3 expression and generated a subpopulation of IFN-γ + /Foxp3 + T cells with suppressive capacity. A differential expression profile of miRNAs in MSC-EVs-treated Th1 cells was seen, and also a modulation of one of their target genes, TGFbR2. MSC-EVs altered the metabolism of Th1-differentiated T cells, suggesting the involvement of the TGF-β pathway in this metabolic modulation. The addition of MSC-EVs in vivo, in an OVA immunization model, generated cells Foxp3 + . Thus, our findings suggest that MSC-EVs are able to specifically modulate activated T cells at an alternative regulatory profile by miRNAs and metabolism shifting.Cells 2020, 9, 1059 2 of 27 different biologic functions, which include, besides cell differentiation in multiple lines, tissue repair and immunosuppression. MSCs can modulate innate cells such as monocytes and macrophages, DCs and NK cells [3] and cells of the adaptive immune system, preventing the proliferation of CD4 + and CD8 + T cells and B cells. The effect of MSCs on T cells modulation is more widely studied. These cells suppress the proliferation of CD4 + and CD8 + naïve and memory T cells [4,5]. The presence of MSCs in lymphocyte culture may also lead to increase of regulatory T cell subpopulations (Treg) [6-9], a subtype essential for the suppression of immune response and tolerance induction [10]. Studies that pursue to identify the mechanisms by which MSCs exert their regulation suggest that the paracrine effect is more important than cell-cell contact, being the main mediator of this action [3]. In this context, the release of soluble factors with immunomodulatory properties, such as HGF [11], TGF-β [7], IL-10 [12], prostaglandin-E 2 (PGE 2 ) [13], indoleamine-2,3-dioxygenase (IDO) [14], has been identified as responsible for the effects of MSCs in several studies. Recently, nevertheless, the release of extracellular vesicles (EVs) by these cells has been demonstrated as an alternative mechanism by which MSCs perform their biologic effects [15].EVs include several particles which are classified according to their origin and size. Exosomes are small particles (40 to 100 nm in diameter), derived from the endocytic ...