Extracellular vesicles in renal therapeutics: involvement of microRNAs.

Recently, intensive scientific efforts have been directed to investigate the role of small non-coding RNA (miRs) in different renal diseases. Extracellular vesicles (EVs) are small secretory vesicles released from almost all mammalian cells. EVs-miRs cargo plays a significant role in regulating various aspects of the biological machinery of the recipient cells. EVs-miRs may play an essential role in promoting cellular regenerative functions. miRs contained within the EVs fractions are capable of preserving their function throughout their journey from the cell of origin to the host cells. Our review discusses the role of EVs-miRs in different renal diseases as a novel approach to managing particular renal injuries. We have tried to simplify the possible modulatory impact of miRs at ultrastructural cellular pathological signalling, demonstrating both hazardous and beneficial subtypes based on published research. Further investigations are still needed in this regard, as miRs may have dual effects, as EVs-miR-23a could attenuate renal fibrosis through the activation of Akt and the inhibition of FoxO1 signalling. We have found that EVs-miR-23a was upregulated by hypoxia-inducible factor (HIF-1a) in hypoxic TECs and activated macrophages to accelerate the renal inflammatory cytokine storm and promote interstitial fibrosis.