J Cell Physiol. 2019 Jan 4. doi: 10.1002/jcp.27998. [Epub ahead of print]

Extracellular micro/nanovesicles rescue kidney from ischemia-reperfusion injury.

Farzamfar S¹, Hasanpour A², Nazeri N², Razavi H¹, Salehi M^3,4, Shafei S⁵, Nooshabadi VT⁶, Vaez A¹, Ehterami A⁷, Sahrapeyma H⁸, Ai J¹.

Abstract

Acute renal failure (ARF) is a clinical challenge that is highly resistant to treatment, and its high rate of mortality is alarming. Ischemia-reperfusion injury (IRI) is the most common cause of ARF. Especially IRI is implicated in kidney transplantation and can determine graft survival. Although the exact pathophysiology of renal IRI is unknown, the role of inflammatory responses has been elucidated. Because mesenchymal stromal cells (MSCs) have strong immunomodulatory properties, they are under extensive investigation as a therapeutic modality for renal IRI. Extracellular vesicles (EVs) play an integral role in cell-to-cell communication. Because the regenerative potential of the MSCs can be recapitulated by their EVs, the therapeutic appeal of MSC-derived EVs has dramatically increased in the past decade. Higher safety profile and ease of preservation without losing function are other advantages of EVs compared with their producing cells. In the current review, the preliminary results and potential of MSC-derived EVs to alleviate kidney IRI are summarized. We might be heading toward a cell-free approach to treat renal IRI.