Department of Pediatrics, Clinical Sciences Lund, Lund University, Klinikgatan 28, 22184 Lund, Sweden.
Nat Rev Nephrol. 2017 Sep;13(9):545-562. doi: 10.1038/nrneph.2017.98. Epub 2017 Jul 24.
Extracellular vesicles, such as exosomes and microvesicles, are host cell-derived packages of information that allow cell-cell communication and enable cells to rid themselves of unwanted substances. The release and uptake of extracellular vesicles has important physiological functions and may also contribute to the development and propagation of inflammatory, vascular, malignant, infectious and neurodegenerative diseases. This Review describes the different types of extracellular vesicles, how they are detected and the mechanisms by which they communicate with cells and transfer information. We also describe their physiological functions in cellular interactions, such as in thrombosis, immune modulation, cell proliferation, tissue regeneration and matrix modulation, with an emphasis on renal processes. We discuss how the detection of extracellular vesicles could be utilized as biomarkers of renal disease and how they might contribute to disease processes in the kidney, such as in acute kidney injury, chronic kidney disease, renal transplantation, thrombotic microangiopathies, vasculitides, IgA nephropathy, nephrotic syndrome, urinary tract infection, cystic kidney disease and tubulopathies. Finally, we consider how the release or uptake of extracellular vesicles can be blocked, as well as the associated benefits and risks, and how extracellular vesicles might be used to treat renal diseases by delivering therapeutics to specific cells.
细胞外囊泡，如外泌体和微泡，是宿主细胞来源的信息包，允许细胞间通讯，并使细胞能够清除不需要的物质。细胞外囊泡的释放和摄取具有重要的生理功能，也可能有助于炎症、血管、恶性、感染和神经退行性疾病的发展和传播。本综述描述了不同类型的细胞外囊泡，它们的检测方法以及它们与细胞通讯和传递信息的机制。我们还描述了它们在细胞相互作用中的生理功能，如血栓形成、免疫调节、细胞增殖、组织再生和基质调节，重点是肾脏过程。我们讨论了如何利用细胞外囊泡作为肾脏疾病的生物标志物，以及它们如何在肾脏疾病过程中发挥作用，如急性肾损伤、慢性肾脏病、肾移植、血栓性微血管病、血管炎、IgA 肾病、肾病综合征、尿路感染、囊性肾病和肾小管病。最后，我们考虑了如何阻断细胞外囊泡的释放或摄取，以及相关的益处和风险，以及如何通过将治疗剂递送到特定细胞来利用细胞外囊泡治疗肾脏疾病。
