Stem cell extracellular vesicles and kidney injury

Abstract

Extracellular vesicles (EVs) appear as a new promising cell-free therapy for acute and chronic renal diseases. EVs retain characteristics of the cell of origin and those derived from stem cells may mimic their regenerative properties per se. In fact, EVs contain many active molecules such as proteins and RNA species that act on target cells through different mechanisms, stimulating proliferation and angiogenesis and reducing apoptosis and inflammation. There are several reports that demonstrate a general regenerative potential of EVs derived from mesenchymal stromal cells (MSCs) of different sources in kidney injury models. In addition, a promising new approach is the use of EVs in the graft perfusion solution for kidney conditioning before transplant. Here we summarize the application of EVs released by stem cells in preclinical models of acute and chronic renal damage, comparing animal models, use of EVs of different cell origin and of their sub-fractions, doses, route of administration and efficacy of treatment.

Keywords: Exosomes; acute kidney injury (AKI); chronic kidney disease (CKD); fractions; renal regeneration.

Figure 1

EV treatment in renal injury. Possible EV strategies in AKI, CKD and kidney pre-transplant conditioning. EV, extracellular vesicle; AKI, acute kidney injury; CKD, chronic kidney disease; DCD, donation after circulatory death; GFR, glomerular filtration rate.