Mesenchymal stem cells (MSCs) are multi-potent cells, which can differentiate into mesenchymal and trans-differentiate to non-mesenchymal tissues in vitro and in vivo (
1). They are found in specialized tissues of the body like the brain, bone marrow, Wharton jelly, pulp and umbilical cord blood (
2). Stem cells and especially MSCs produce all types of multicellular tissues in the body via proliferation and differentiation in controlled in vivo environments. These cells are characterized by their easy access, expanding potential in vitro and features that are not easily lost (
3). Bone-marrow mesenchymal stem cells (BMSCs) are non-hematopoietic stromal cells with powerful proliferative and differential potential and represent interesting modalities for the establishment of efficient stem cell-based therapy in various diseases. In the recent years, there has been growing interest in MSC application in cell-based therapy (
4-
6). However, MSCs-based therapy faces some limitations such as low proliferation and survival rate (
7-
9) after replacement in an in vivo environment (
10-
12). Following MSCs transplantation, the cells are faced with factors such as low serum, hypoxia, heat shock, and oxygen free radicals. This environment-induced cell death and apoptosis hours after transplantation (
13). There are several strategies to improve survival rate, potency, migration and targeting of MSCs. Some studies have reported that preconditioning of MSCs by cultivation under H
2O
2, hypoxic and serum deprivation as well as sub-lethal stress environment improves the survival and proliferation rates, differentiation and migration capacities (
14,
15). Preconditioning using H
2O
2 is the most practical and important protocol applied in preclinical studies. It has been suggested that preconditioning exerts its effects through altering intrinsic signaling pathways of growth factors, cytokines, and chemokines and expression level of their receptors and consequently improves stem cells survival and proliferation rate (
16,
17). Treatment of MSCs with low concentrations of H
2O
2 for a short period of time adapts them to harmful conditions. It protects MSCs against oxidative damage upon their exposure to high concentrations of reactive oxygen species (ROS) and prevents apoptosis induction as well (
18). Enhancement of heart function and decrease of myocardial fibrosis have been reported following transplantation of H
2O
2 preconditioned MSCs to infracted myocardium in mice (
19). Interestingly, H
2O
2 preconditioning decreases serum deprivation (SD)-induced apoptosis.