Urinary extracellular vesicles (uEVs), released from cells of the urogenital tract organs, carry precious information about originating tissues. The study of molecules transported through uEVs such as
proteins,
lipids and
nucleic acids provides a deeper understanding of the function of the kidney, an organ involved in the pathogenesis of
hypertension and a target of
hypertension-mediated organ damage. Molecules derived from uEVs are often proposed for the study of disease pathophysiology or as possible disease diagnostic and prognostic
biomarkers. Analysis of
mRNA loading within uEVs may be a unique and readily obtainable way to assess gene expression patterns of renal cells, otherwise achievable only by an invasive biopsy procedure. Interestingly, the only few studies investigating transcriptomics of
hypertension-related genes through the analysis of
mRNA from uEVs are inherent to
mineralocorticoid hypertension. More specifically, it has been observed that perturbation in human endocrine signalling through mineralcorticoid receptors (MR) activation parallels changes of
mRNA transcripts in urine supernatant. Furthermore, an increased copy number of uEVs-extracted
mRNA transcripts of the 11β-hydroxysteroid
dehydrogenase type 2 (HSD11B2) gene were detected among subjects affected by apparent
mineralocorticoid excess (
AME), a
hypertension-inducing autosomal recessive disorder due to a defective
enzyme function. Moreover, by studying uEVs
mRNA, it was observed that the renal
sodium chloride cotransporter (NCC) gene expression is modulated under different conditions related to
hypertension. Following this perspective, we illustrate here the state of the art and the possible future of uEVs transcriptomics towards a deeper knowledge of
hypertension pathophysiology and ultimately more tailored investigational, diagnostic-prognostic approaches.