Lupus nephritis (LN) is a major cause for overall morbidity and mortality in patients with systemic lupus erythematosus (SLE), while its pathogenic mechanisms are still not well understood. Extracellular vesicles (EVs) are membrane vesicles that are released from almost all cell types. EVs can be subdivided into exosomes, microvesicles, and apoptotic bodies. Latest studies have shown that EVs can be released during several cellular events, including cell activation, autophagy, and several types of programed cell death, i.e. apoptosis, necroptosis, pyroptosis, and NETosis. Emerging evidence demonstrates that EVs harbor different bioactive molecules, including nucleic acids, proteins, lipids, cytokines, immune complexes (ICs), complements, and other molecules, some of which may contribute to pathogenesis of autoimmune diseases. EVs can serve as novel information shuttle to mediate local autocrine or paracrine signals to nearby cells, and distant endocrine signals to cells located far away. In LN, EVs may have pathogenic effects by transportation of autoantigens or complements, promotion of IC deposition or complement activation, and stimulation of inflammatory responses, renal tissue injury, or microthrombus formation. Additionally, EVs released from kidney cells may serve as specific biomarkers for diagnosis or monitoring of disease activity and therapeutic efficacy. In this review, we will summarize the latest progress about EV generation from basic research, their potential pathologic effects on LN, and their clinical implications. The cutting-edge knowledge about EV research provides insights into novel therapeutic strategy, new tools for diagnosis or prognosis, and evaluation approaches for treatment effectiveness in LN.

狼疮性肾炎（LN）是系统性红斑狼疮（SLE）患者总体发病和死亡的主要原因，但其致病机制仍不清楚。细胞外囊泡 (EV) 是几乎所有细胞类型都会释放的膜囊泡。EV可细分为外泌体、微泡和凋亡小体。最新研究表明，EVs可以在多种细胞事件中释放，包括细胞激活、自噬和几种类型的程序性细胞死亡，即细胞凋亡、坏死性凋亡、细胞焦亡和NETosis。新的证据表明，EVs 含有不同的生物活性分子，包括核酸、蛋白质、脂质、细胞因子、免疫复合物 (IC)、补体和其他分子，其中一些可能有助于自身免疫性疾病的发病机制。EVs可以作为新型信息穿梭机，将局部自分泌或旁分泌信号传递给附近的细胞，并将远程内分泌信号传递给远处的细胞。在 LN 中，EV 可能通过运输自身抗原或补体、促进 IC 沉积或补体激活、刺激炎症反应、肾组织损伤或微血栓形成而产生致病作用。此外，肾细胞释放的 EV 可作为诊断或监测疾病活动和治疗效果的特异性生物标志物。在这篇综述中，我们将总结EV产生的基础研究最新进展、它们对LN的潜在病理作用及其临床意义。EV 研究的前沿知识为 LN 的新治疗策略、诊断或预后新工具以及治疗效果评估方法提供了见解。