Anti-fibrotic and anti-inflammatory effect of mesenchymal stromal cell-derived extracellular vesicles in chronic kidney disease

Renal fibrosis and inflammation are common pathological features of chronic kidney disease (CKD). Since currently available treatments can only delay the progression of CKD, the outcome of patients with CKD is still poor. One therapeutic option for the prevention of CKD-related complications could be the use of mesenchymal stromal cells (MSCs), which have shown beneficial effects in tissue fibrosis and regeneration after damage. However, safety issues, such as cellular rejection and carcinogenicity, limit their clinical application. Among the bioactive factors secreted by MSCs, extracellular vesicles (EVs) have shown the same beneficial effect of MSCs, without any notable side effects. This heterogeneous population of membranous nano-sized particles can deliver genetic material and functional proteins to injured cells, prompting tissue regeneration. Here we describe the anti-fibrotic and anti-inflammatory properties of MSC-derived EVs in CKD preclinical models and summarize the potential molecular mechanisms involved in the regulation of renal fibrosis and inflammation.