Extracellular vesicles are released by the majority of cell types and circulate in body fluids. They function as a long-distance cell-to-cell communication mechanism that modulates the gene expression profile and fate of target cells. Increasing evidence has established a central role of extracellular vesicles in kidney physiology and pathology. Urinary extracellular vesicles mediate crosstalk between glomerular and tubular cells and between different segments of the tubule, whereas circulating extracellular vesicles mediate organ crosstalk and are involved in the amplification of kidney damage and inflammation. The molecular profile of extracellular vesicles reflects the type and pathophysiological status of the originating cell so could potentially be exploited for diagnostic and prognostic purposes. In addition, robust preclinical data suggest that administration of exogenous extracellular vesicles could promote kidney regeneration and reduce inflammation and fibrosis in acute and chronic kidney diseases. Stem cells are thought to be the most promising source of extracellular vesicles with regenerative activity. Extracellular vesicles are also attractive candidates for drug delivery and various engineering strategies are being investigated to alter their cargo and increase their efficacy. However, rigorous standardization and scalable production strategies will be necessary to enable the clinical application of extracellular vesicles as potential therapeutics.

细胞外囊泡由大多数细胞类型释放并在体液中循环。它们充当调节基因表达谱和靶细胞命运的长距离细胞间通讯机制。越来越多的证据证实了细胞外囊泡在肾脏生理学和病理学中的核心作用。尿液细胞外囊泡介导肾小球和肾小管细胞之间以及肾小管不同部分之间的串扰，而循环细胞外囊泡介导器官串扰并参与肾脏损伤和炎症的放大。细胞外囊泡的分子特征反映了原始细胞的类型和病理生理状态，因此可能被用于诊断和预后目的。此外，可靠的临床前数据表明，给予外源性细胞外囊泡可以促进肾脏再生并减少急性和慢性肾脏疾病的炎症和纤维化。干细胞被认为是具有再生活性的细胞外囊泡最有希望的来源。细胞外囊泡也是药物递送的有吸引力的候选者，并且正在研究各种工程策略以改变它们的货物并提高它们的功效。然而，严格的标准化和可扩展的生产策略将是必要的，以使细胞外囊泡作为潜在疗法的临床应用成为可能。干细胞被认为是具有再生活性的细胞外囊泡最有希望的来源。细胞外囊泡也是药物递送的有吸引力的候选者，并且正在研究各种工程策略以改变它们的货物并提高它们的功效。然而，严格的标准化和可扩展的生产策略将是必要的，以使细胞外囊泡作为潜在疗法的临床应用成为可能。干细胞被认为是具有再生活性的细胞外囊泡最有希望的来源。细胞外囊泡也是药物递送的有吸引力的候选者，并且正在研究各种工程策略以改变它们的货物并提高它们的功效。然而，严格的标准化和可扩展的生产策略将是必要的，以使细胞外囊泡作为潜在疗法的临床应用成为可能。