Update on current and potential application of extracellular vesicles in kidney transplantation.

Abstract

Kidney transplantation (KT) is the best treatment for end-stage kidney disease. However, early diagnosis of graft injury remains challenging, mainly because of the lack of accurate and noninvasive diagnostic techniques. Improving graft outcomes is equally demanding, as is the development of innovative therapies. Many research efforts are focusing on extracellular vesicles, cellular particles free in each body fluid that have shown promising results as precise markers of damage and potential therapeutic targets in many diseases, including the renal field. In fact, through their receptors and cargo, they act in damage response and immune modulation. In transplantation, they may be used to determine organ quality and aging, the presence of delayed graft function, rejection, and many other transplant-related pathologies. Moreover, their low immunogenicity and safe profile make them ideal for drug delivery and the development of therapies to improve KT outcomes. In this review, we summarize current evidence about extracellular vesicles in KT, starting with their characteristics and major laboratory techniques for isolation and characterization. Then, we discuss their use as potential markers of damage and as therapeutic targets, discussing their promising use in clinical practice as a form of liquid biopsy.

• Authors: Matteo Abinti, Evaldo Favi, Carlo Maria Alfieri, Francesca Zanoni, Silvia Armelloni, Mariano Ferraresso, Vincenzo Cantaluppi, Giuseppe Castellano
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 23 Issue 11 Pg. 1673-1693 (11 2023) ISSN: 1600-6143 [Electronic] United States
• PMID: 37517555 (Publication Type: Journal Article, Review, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2023 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Humans
• Kidney Transplantation (adverse effects)
• Kidney
• Kidney Failure, Chronic (surgery)
• Extracellular Vesicles
• Graft Rejection (diagnosis, etiology, prevention & control)