Department of Surgery, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK.
Department of Surgery, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK; Blood and Transplant Research Unit in Organ Donation and Transplantation, National Institute for Health Research, University of Cambridge, Cambridge, UK.
Kidney Int. 2022 Mar;101(3):485-497. doi: 10.1016/j.kint.2021.10.038. Epub 2021 Nov 26.
Kidney transplantation is the optimal treatment for patients with kidney failure; however, early detection and timely treatment of graft injury remain a challenge. Precise and noninvasive techniques of graft assessment and innovative therapeutics are required to improve kidney transplantation outcomes. Extracellular vesicles (EVs) are lipid bilayer-delimited particles with unique biosignatures and immunomodulatory potential, functioning as intermediaries of cell signalling. Promising evidence exists for the potential of EVs to develop precision diagnostics of graft dysfunction, and prognostic biomarkers for clinician decision making. The inherent targeting characteristics of EVs and their low immunogenic and toxicity profiles combined with their potential as vehicles for drug delivery make them ideal targets for development of therapeutics to improve kidney transplant outcomes. In this review, we summarize the current evidence for EVs in kidney transplantation, discuss common methodological principles of EV isolation and characterization, explore upcoming innovative approaches in EV research, and discuss challenges and opportunities to enable translation of research findings into clinical practice.
肾移植是肾衰竭患者的最佳治疗方法；然而，早期发现和及时治疗移植物损伤仍然是一个挑战。需要精确和非侵入性的移植物评估技术和创新的治疗方法来改善肾移植的结果。细胞外囊泡（EVs）是具有独特生物特征和免疫调节潜力的脂质双层限定颗粒，作为细胞信号转导的中介。有令人鼓舞的证据表明，EVs 有可能开发出用于检测移植物功能障碍的精准诊断方法，以及用于临床医生决策的预后生物标志物。EVs 的固有靶向特性及其低免疫原性和低毒性特征，加上它们作为药物递送载体的潜力，使它们成为改善肾移植结果的治疗药物开发的理想目标。在这篇综述中，我们总结了 EVs 在肾移植中的现有证据，讨论了 EV 分离和表征的常见方法学原则，探讨了 EV 研究中的新方法，并讨论了将研究结果转化为临床实践的挑战和机遇。
