Yan Qianqian, Liu Mengyuan, Mao Jinyan, Zhao Zihao, Wang Bo
Nephrology Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People's Republic of China.
Department of Anesthesiology, Air Force Hospital of Western Theater Command, PLA, Chengdu, 610011, People's Republic of China.
Int J Nanomedicine. 2025 May 17;20:6271-6288. doi: 10.2147/IJN.S519345. eCollection 2025.
Acute kidney injury (AKI) has a high morbidity and mortality rate but can only be treated with supportive therapy in most cases. The diagnosis of AKI is mainly based on serum creatinine level and urine volume, which cannot detect kidney injury sensitive and timely. Therefore, new diagnostic and therapeutic molecules of AKI are being actively explored. Extracellular vesicles (EVs), secreted by almost all cells, can originate from different parts of the kidney and mediate intercellular communication between various cell types of nephrons. At present, numerous successful EV-based biomarker discoveries and treatments for AKI have been made, such as the confirmed diagnostic role of urine-derived EVs in AKI and the established therapeutic role of mesenchymal stem cell-derived EVs in AKI have been confirmed; however, these related studies lack a full discussion. In this review, we summarize the latest progression in the profound understanding of the functional role of EVs in AKI caused by various etiologies in recent years and provide new insights into EVs as viable biomarkers and therapeutic molecules for AKI patients. Furthermore, the current challenges and prospects of this research area are briefly discussed, presenting a comprehensive overview of the growing foregrounds of EVs in AKI.
急性肾损伤（AKI）发病率和死亡率较高，但在大多数情况下只能进行支持性治疗。AKI的诊断主要基于血清肌酐水平和尿量，无法灵敏且及时地检测出肾损伤。因此，人们正在积极探索AKI的新型诊断和治疗分子。几乎所有细胞分泌的细胞外囊泡（EVs）可源自肾脏不同部位，并介导肾单位各种细胞类型之间的细胞间通讯。目前，基于EVs在AKI方面已有众多成功的生物标志物发现及治疗成果，比如已证实尿液来源的EVs在AKI中的诊断作用以及间充质干细胞来源的EVs在AKI中的治疗作用；然而，这些相关研究缺乏全面探讨。在本综述中，我们总结了近年来对EVs在各种病因所致AKI中功能作用深入理解的最新进展，并为将EVs作为AKI患者可行的生物标志物和治疗分子提供新见解。此外，还简要讨论了该研究领域当前面临的挑战和前景，全面概述了EVs在AKI中不断发展的前景。
