Abstract
Exosomes are nanometer-sized small EVs coated with bilayer structure, which are released by prokaryotic and eukaryotic cells. Exosomes are rich in a variety of biologically active substances, such as proteins, nucleotides, and lipids. Exosomes are widely present in various body fluids and cell culture supernatants, and it mediates the physiological and pathological processes of the body through the shuttle of these active ingredients to target cells. In recent years, studies have shown that exosomes from a variety of cell sources can play a beneficial role in acute and chronic kidney disease. In particular, exosomes derived from mesenchymal stem cells have significant curative effects on the prevention and treatment of kidney disease in preclinical trials. Besides, some encapsulated substances are demonstrated to exert beneficial effects on various diseases, so they have attracted much attention. In addition, exosomes have extensive sources, stable biological activity, and good biocompatibility and are easy to store and transport; these advantages endow exosomes with superior diagnostic value. With the rapid development of liquid biopsy technology related to exosomes, the application of exosomes in the rapid diagnosis of kidney disease has become more prominent. In this review, the latest development of exosomes, including the biosynthesis process, the isolation and identification methods of exosomes are systematically summarized. The utilization of exosomes in diagnosis and their positive effects in the repair of kidney dysfunction are discussed, along with the specific mechanisms. This review is expected to be helpful for relevant studies and to provide insight into future applications in clinical practice.
Highlights
There are many types of kidney diseases
We demonstrated that hucMSC-Exos could promote the translocation of glucose transporters 4 (GLUT4) to enhance glucose uptake, activate the insulin/AKT pathway to increase insulin sensitivity, and change the quality and quantity of pancreatic β-cells [146]
Due to the exploration of novel bioactive markers and the pursuit of noninvasive diagnosis, the cargos encapsulated in exosomes have garnered considerable research attention in their ability to promote early diagnosis and treatment and to relieve pain as soon as possible
Summary
There are many types of kidney diseases. According to etiological factor, kidney diseases can be divided into primary, secondary, and congenital diseases. Many studies have reported therapeutic roles of exosomes secreted by cultured cells Thanks to their reflection of host cells and existence in body fluids, studies have demonstrated the potential molecules which are associated with the diagnosis and prognosis of kidney diseases. This review summarizes those studies and provides insight into the possible use of exosomes. Various methods are traditionally used to isolate exosomes, such as sequential ultracentrifugation, ultrafiltration, sizeexclusion chromatography, immune-affinity capture, and polymer precipitation (Figure 1). These methods depend on physical, chemical, and biological properties [23]. Attempts to recognize the underlying mechanisms of different EVs make it important for us to prevent this progression and seek means of addressing illness
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