Mesenchymal stem cells-derived extracellular vesicles in the treatment and repair of acute and chronic renal injuries
Li Qingru, Zhang Linqi, Chen Xu, Shi Ruoyu, Wang Xixi
First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou 453000, Henan Province, China
Abstract: BACKGROUND: Stem cells, especially extracellular vesicles derived from mesenchymal stem cells, have the potential to promote regeneration in different renal injury models.
OBJECTIVE: To review the application progress of extracellular vesicles derived from mesenchymal stem cells in preclinical models of acute and chronic renal injuries and the latest data in renal transplantation. In addition, new engineering strategies to improve the therapeutic effect of extracellular vesicles were discussed.
METHODS: CNKI, Wanfang, and PubMed databases were searched. The Chinese search words included “acute renal injury, chronic kidney disease, extracellular vesicles, exosomes”. English search words included “acute renal injury, chronic kidney disease, extracellular vesicles, exosomes, regeneration”. The search literature was the original research works and reviews. The retrieval time limit was from the establishment of the database to 2021, and 82 articles were selected for analysis and summary.
RESULTS AND CONCLUSION: (1) The research on mesenchymal stem cell derived extracellular vesicles in the treatment of renal injury has been widely carried out. Animal experiments have confirmed that mesenchymal stem cell derived extracellular vesicles can play a renal protective role and delay the progress of disease in the treatment of acute and chronic renal injuries. The specific mechanism involves the reprogramming of injured cells, cell proliferation, angiogenesis and inhibition of apoptosis and inflammation. Immediate administration of extracellular vesicles after renal transplantation can improve acute and chronic ischemia-reperfusion injuries. (2) There are few clinical trials on the treatment of nephropathy with mesenchymal stem cell-derived extracellular vesicles. One clinical trial observed that one year after taking umbilical cord blood mesenchymal stem cell-derived extracellular vesicles, the renal function of patients with chronic kidney disease was improved. (3) Based on the above research, mesenchymal stem cells derived extracellular vesicles will help to provide a new experimental model and basis for the effective treatment and repair of acute and chronic renal injuries, and open up a new direction for the clinical treatment of renal diseases.
Key words: acute renal injury, chronic kidney disease, renal transplantation, mesenchymal stem cell, extracellular vesicles, exosomes, creatinine, urea nitrogen, kidney, regenerative medicine