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The schematic workflow illustrates next-generation sequencing of lung-derived mesenchymal stromal cells (MSCs) from IPF patients and controls. Rather than broad epigenetic reprogramming, IPF-MSCs exhibit a remarkably restricted down-regulation of only three critical microRNAs: hsa-miR-373-3p, hsa-miR-486-5p, and hsa-miR-449a. This selective dysregulation leads to the targeted upregulation of key profibrotic genes (SMAD4, BCL2, TGF-β, CXCL12, VEGF), driving TGF-β cascade activation, altered autophagy, and profibrotic and proangiogenic signaling.