Exploring the role of urinary extracellular vesicles in kidney physiology, aging, and disease progression

Abstract

Extracellular vesicles (EVs), membranous vesicles present in all body fluids, are considered important messengers, carrying their information over long distance and modulating the gene expression profile of recipient cells. EVs collected in urine (uEVs) are mainly originated from the apical part of urogenital tract, following the urine flow. Moreover, bacterial derived EVs are present within urine and may reflect the composition of microbiota. Consolidated evidence has established the involvement of uEVs in renal physiology, being responsible for glomerular and tubular cross-talk and among different tubular segments. uEVs may also be involved in other physiologic functions such as modulation of innate immunity, coagulation or metabolic activities. Furthermore, it has been recently remonstrated that age, sex, endurance excise and lifestyle may influence uEV composition and release, modifying their cargo. On the other hand, uEVs appear modulators of different urogenital pathological conditions, triggering disease progression. uEVs sustain fibrosis and inflammation processes, both involved in acute and chronic kidney diseases, ageing and stone formation. The molecular signature of uEVs collected from diseased patients can be of interest for understanding kidney physiopathology and for identifying diagnostic and prognostic biomarkers.

Extracellular vesicles: Function, resilience, biomarker, bioengineering, and clinical implications

“…Similarly, EVs have demonstrated a crucial function in maintaining cellular and physiological resilience during periods of stress [ 24 25 ]. However, dysregulation of EV-mediated signaling pathways is implicated in the pathogenesis of numerous diseases, including excessive inflammation, cancer, cardiovascular disorders, kidney pathology, neurodegenerative diseases, and pathogen invasions [ 18 19 20 21 22 70 71 ]. Unraveling the roles of EVs in both normal physiology and pathophysiology is critical for harnessing their therapeutic potential and developing innovative strategies for disease intervention.…”

“…EVs facilitate the transfer of bioactive molecules such as microRNAs (miRNAs), proteins, and lipids between cells, thereby influencing recipient cell function and behavior. In normal physiology, EVs participate in processes such as tissue regeneration, immune modulation, and neuronal communication [ 18 19 20 21 22 ]. When a cell faces adversity, EVs come bearing gifts of resilience.…”

Is Vesicular Therapy the Newcomer That Matters for the Medicine of Tomorrow?

“…As there is still no codified nomenclature, EVs can be categorized according to various features: e.g., their biogenesis (such as exosomes from the endosomal pathway) or their size (such as small or large EVs) [ 1 ]. The cargo carried by EVs reflects the biological state of the parent cell, influencing recipient cells in various physiological and pathological processes [ 2 ]. Research on EVs has expanded rapidly these last twenty years due to their potential diagnostic and therapeutic applications [ 3 ].…”