Wang Weidong, Wang Jingyu, Liao Dan
Department of Nephrology, Mianyang Central Hospital, Mianyang 621000, China.
Renal Division, Peking University First Hospital, Beijing 100080, China.
Stem Cells Int. 2025 Mar 24;2025:1075016. doi: 10.1155/sci/1075016. eCollection 2025.
Acute kidney injury (AKI) is a rapid decline in renal function caused by ischemia/reperfusion (I/R), renal toxic injury, and sepsis. While the precise molecular mechanisms underlying AKI are still under investigation, current therapeutic approaches remain insufficient. In recent years, there has been growing evidence that mesenchymal stem cells (MSCs) have great potential in accelerating renal repair after AKI in various preclinical models, while there has been extensive research on extracellular vesicles (EVs) as therapeutic mediators in AKI models, and they are considered to be superior to MSCs as new regenerative therapies. EVs are nanoparticles secreted by various types of cells under physiological and pathological conditions. EVs derived from various sources possess biomarker potential and play crucial roles in mediating cellular communication between kidney cells and other tissue cells by transmitting signal molecules. These vesicles play a direct and indirect role in regulating the pathophysiological mechanisms of AKI and contribute to the occurrence, development, treatment, and repair of AKI. In this review, we briefly outline the essential characteristics of EVs, focus on the multiple molecular mechanisms currently involved in the protection of EVs against different types of AKI, and further discuss the potential targets of EVs from different sources in the treatment of AKI. Finally, we summarized the deficiencies in the production and treatment of EVs and the current strategies for improvement.
急性肾损伤（AKI）是由缺血/再灌注（I/R）、肾毒性损伤和脓毒症引起的肾功能快速下降。虽然AKI潜在的精确分子机制仍在研究中，但目前的治疗方法仍然不足。近年来，越来越多的证据表明，间充质干细胞（MSCs）在各种临床前模型中对加速AKI后的肾脏修复具有巨大潜力，同时，作为AKI模型中的治疗介质，细胞外囊泡（EVs）也得到了广泛研究，并且它们被认为作为新的再生疗法优于MSCs。EVs是各种类型细胞在生理和病理条件下分泌的纳米颗粒。来自各种来源的EVs具有生物标志物潜力，并通过传递信号分子在介导肾细胞与其他组织细胞之间的细胞通讯中发挥关键作用。这些囊泡在调节AKI的病理生理机制中发挥直接和间接作用，并有助于AKI的发生、发展、治疗和修复。在本综述中，我们简要概述了EVs的基本特征，重点关注目前EVs对不同类型AKI的保护所涉及的多种分子机制，并进一步讨论不同来源的EVs在AKI治疗中的潜在靶点。最后，我们总结了EVs生产和治疗方面的不足以及当前的改进策略。
