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3209-A ENGINEERED MESENCHYMAL STEM CELL-DERIVED EXOSOMES PROMOTE MACROPHAGE EFFEROCYTOSIS VIA ADAM9/MERTK AXIS IN ACUTE-ON-CHRONIC LIVER FAILURE Junyi Wang 1 , Zhihui Li 2 , Shibo Meng 3 , Junfeng Chen 1 , Bingliang Lin 3 and Jing Zhang 4 , (1)The Third Affiliated Hospital of Sun Yat-Sen University, (2)Sun Yat-Sen University, (3)The Third Affiliated Hospital, Sun Yat-Sen University, (4)Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-Sen University Background: Acute-on-Chronic liver failure is a disease with a high mortality rate, the only cure currently available is liver transplantation.Our previous study showed that intravenous injection of mesenchymal stem cells could improve survival rate of acute-on-chronic liver failure patients, and expressed higher levels of Mertk, which could promote macrophage phagocytosis of apoptotic cells and reduced the occurrence of secondary necrosis in the efferocytosis .Mertk can be cleaved by a cell membrane protein ADAM9 and subsequently loses its biological activity.MiR-126 is an upstream molecule of ADAM9 that can inhibit its generation.In this study,we aim to load miR-126 into exosomes of mesenchymal stem cells by electroporation as engineered exosomes,then apply it to the treatment of acute-on-chronic cell model and explore the mechanism