Extracellular vesicles (EVs) are small, lipid bilayer-delimited particles of cellular origin that recently gained increasing attention for their potential use as diagnostic biomarkers, and beyond that for their role in intercellular communication and as regulators of homeostatic and disease processes. In acute kidney injury (AKI) and chronic kidney disease (CKD), the potential use of EVs as diagnostic and prognostic markers has been evaluated in a series of clinical studies and contributions to pathophysiologic pathways have been investigated in experimental models. While EV concentrations in biofluids could not distinguish renal patients from healthy subjects or determine disease progression, specific EV subpopulations have been identified that may provide useful diagnostic and prognostic tools in AKI. Specific EV subpopulations are also associated with clinical complications in sepsis-induced AKI and in CKD. Beyond their role as biomarkers, pathophysiologic involvement of EVs has been shown in hemolytic uremic syndrome- and sepsis-induced AKI as well as in cardiovascular complications of CKD. On the other hand, some endogenously formed or therapeutically applied EVs demonstrate protective effects pointing toward their usefulness as emerging treatment strategy in kidney disease.

中文翻译：

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细胞外囊泡作为肾功能和疾病的调节剂

细胞外囊泡 (EV) 是细胞来源的由脂质双层分隔的小颗粒，最近因其作为诊断生物标志物的潜在用途而受到越来越多的关注，除此之外，它们在细胞间通讯中的作用以及作为稳态和疾病过程的调节剂。在急性肾损伤 (AKI) 和慢性肾病 (CKD) 中，EV 作为诊断和预后标志物的潜在用途已在一系列临床研究中得到评估，并在实验模型中研究了对病理生理学途径的贡献。虽然生物流体中的 EV 浓度无法区分肾脏患者与健康受试者或确定疾病进展，但已确定特定的 EV 亚群可能为 AKI 提供有用的诊断和预后工具。特定的 EV 亚群也与败血症诱导的 AKI 和 CKD 的临床并发症有关。除了作为生物标志物的作用外，EVs 的病理生理学参与已显示在溶血性尿毒症综合征和败血症诱导的 AKI 以及 CKD 的心血管并发症中。另一方面，一些内源性形成或治疗应用的 EV 表现出保护作用，表明它们作为肾脏疾病的新兴治疗策略是有用的。