Extracellular vesicles in kidney transplantation: a state-of-the-art review

James Ashcroft; Philippa Leighton; Tegwen R Elliott; Sarah A Hosgood; Michael L Nicholson; Vasilis Kosmoliaptsis

doi:10.1016/j.kint.2021.10.038

Extracellular vesicles in kidney transplantation: a state-of-the-art review

Kidney Int. 2022 Mar;101(3):485-497. doi: 10.1016/j.kint.2021.10.038. Epub 2021 Nov 26.

Authors

James Ashcroft¹, Philippa Leighton¹, Tegwen R Elliott¹, Sarah A Hosgood², Michael L Nicholson², Vasilis Kosmoliaptsis³

Affiliations

¹ Department of Surgery, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK.
² Department of Surgery, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK; Blood and Transplant Research Unit in Organ Donation and Transplantation, National Institute for Health Research, University of Cambridge, Cambridge, UK.
³ Department of Surgery, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK; Blood and Transplant Research Unit in Organ Donation and Transplantation, National Institute for Health Research, University of Cambridge, Cambridge, UK. Electronic address: vk256@cam.ac.uk.

PMID: 34838864
DOI: 10.1016/j.kint.2021.10.038

Abstract

Kidney transplantation is the optimal treatment for patients with kidney failure; however, early detection and timely treatment of graft injury remain a challenge. Precise and noninvasive techniques of graft assessment and innovative therapeutics are required to improve kidney transplantation outcomes. Extracellular vesicles (EVs) are lipid bilayer-delimited particles with unique biosignatures and immunomodulatory potential, functioning as intermediaries of cell signalling. Promising evidence exists for the potential of EVs to develop precision diagnostics of graft dysfunction, and prognostic biomarkers for clinician decision making. The inherent targeting characteristics of EVs and their low immunogenic and toxicity profiles combined with their potential as vehicles for drug delivery make them ideal targets for development of therapeutics to improve kidney transplant outcomes. In this review, we summarize the current evidence for EVs in kidney transplantation, discuss common methodological principles of EV isolation and characterization, explore upcoming innovative approaches in EV research, and discuss challenges and opportunities to enable translation of research findings into clinical practice.

Keywords: extracellular vesicles; graft survival; kidney transplantation.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Drug Delivery Systems / methods
Extracellular Vesicles*
Humans
Kidney Transplantation* / adverse effects
Renal Insufficiency*