Extracellular Vesicles in Acute Kidney Injury.

Extracellular vesicles (EVs) are promising novel cellular communicators and biomarkers in acute kidney injury (AKI). These submicron vesicles derive from all cell types along the urinary tract and reflect molecular processes of their parent cells and physiological and pathological conditions in AKI. Several EV protein and RNA biomarker candidates have been identified. They have shown to differentiate AKI etiology and pinpoint to disease mechanisms. In fact, EV research has opened up a new frontier of biomarker discovery since some less abundant biomarkers are concentrated in EVs, which makes them more easily detectable. EVs are also functional and are involved in intra-nephron communication. Tubular-interstitial communication is current focus in EV research in AKI as it can help to understand maladaptive processes in AKI. EVs are also promising therapeutic tools and have been shown to be regenerative in many different models of AKI. Rigorous studies are needed to validate these findings, and more sensitive EV detection and characterization tools need to be developed to dissect EV biology in renal disease and AKI.