Urinary Extracellular Vesicles in Chronic Kidney Disease: From Bench to Bedside?

Abstract

Extracellular vesicles are a diverse group of particles that include exosomes, microvesicles, and apoptotic bodies and are defined by size, composition, site of origin, and density. They incorporate various bioactive molecules from their cell of origin during formation, such as soluble proteins, membrane receptors, nucleic acids (mRNAs and miRNAs), and lipids, which can then be transferred to target cells. Extracellular vesicles/exosomes have been extensively studied as a critical factor in pathophysiological processes of human diseases. Urinary extracellular vesicles could be a promising liquid biopsy for determining the pattern and/or severity of kidney histologic injury. The signature of urinary extracellular vesicles may pave the way for noninvasive methods to supplement existing testing methods for diagnosing kidney diseases. We discuss the potential role of urinary extracellular vesicles in various chronic kidney diseases in this review, highlighting open questions and discussing the potential for future research.

Urinary exosomal miRNA-451a can be used as a potential noninvasive biomarker for diagnosis, reflecting tubulointerstitial damage and therapeutic response in IgA nephropathy

“…uE are produced by the kidney and pass through almost all kidney cell types. Additionally, uE contain miRNAs, which can be remarkably stable and easily obtained, providing readily available sources in the clinical setting for diagnosis and monitoring, serving as biomarkers for kidney diseases [ 16 ].…”

Comprehensive strategy for identifying extracellular vesicle surface proteins as biomarkers for chronic kidney disease

“…Thus, the cargo of EVs secreted by kidney cells can reflect the kidney’s pathophysiology. cEVs and uEVs in CKD and OCKD patients has been shown to carry specific proteins that are related to lipid metabolism, oxidative stress, inflammation, and fibrosis, which are hallmarks of pathology progression ( D et al, 2023 ; Grange and Bussolati, 2022 ) ( Figure 3 ). uEVs and cEVs have been investigated as potential diagnostic tools in CKD.…”

Unraveling the Multifaceted Roles of Extracellular Vesicles: Insights into Biology, Pharmacology, and Pharmaceutical Applications for Drug Delivery

“…It has recently been shown that 3% of the total urinary protein content originates from EVs [ 37 ]. Although urinary EVs serve as a reservoir of biomarkers that come from the kidneys, ureters, urinary bladder, urethra [ 38 ], and prostate [ 39 ], their secretion and reuptake are essential in intercellular communication along the nephron and thus preservation of homeostasis of the urinary tract [ 40 ].…”