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. 2025 Sep 13;20:11267–11294. doi: 10.2147/IJN.S529311

Table 3.

Effects of Engineered Exosomes in Kidney Disease Models

Source Disease Model Approach Identification Effects Reference
AMSCs (Human) AKI Vivo: BALB/c, cisplatin Metabolic glycoengineering-mediated click chemistry NMR spectroscopy Specifically bind to the overexpressed CD44 in AKI and target the damaged kidneys [126]
Vitro: HK-2, cisplatin
PMSCs (Human) AKI Vivo: C57BL/6, IRI Hydrogels Rheology tests RGD peptides enhanced exosome stability and target cell uptake efficiency, and alleviated kidney injury by inhibiting CASP3 [127]
Vitro: HK-2, H/R, RAW263.7, LPS+IFN-γ
RBCs (C57BL/6J) AKI, CKD Vivo: C57BL/6J, IRI, UUO Phage Western blot Engineered exosomes can reduce inflammation and fibrosis by targeting Kim-1 to accumulate in damaged renal tubules and deliver siRNAs of transcription factors P65 and Snai1 [128]
Vitro: HEK293, TECs, n/s
Satellite cells (C57BL/6J) CKD Vivo: C57BL/6J, UUO Adenovirus n/s miR-29 restored the decrease in the mass of the soleus, tibialis anterior, and EDL muscles induced by UUO and alleviated kidney fibrosis by targeting TGF-β3 [129]
BMSCs (Human) n/s Vitro: HEK293, normal Freeze-thaw and direct mixing Fluorescence microscopy Hybrid exosomes have higher transfection efficiency [130]
UCMSCs (Human) AKI Vivo: ICR, cisplatin Sonication Fluorescence resonance energy transfer Enhanced the uptake rate and targeting of exosomes, promoted the proliferative activity of NRK52E cells, and alleviated renal oxidation and inflammation [131]
Vitro: NRK52E, cisplatin
AMSCs (Human) CKD Vivo: Nu/nu, UUO Lentivirus vector Fluorescence microscopy Activated the PI3K/Akt/eNOS signaling pathway, relieved renal hypoxia and oxidative stress, inhibited EndoMT, and reduced renal fibrosis [132]
Vitro: HUVECs, hypoxia condition
KMSCs (FVB/N) CKD Vivo: FVB/N, renal anaemia Lentiviral vector Fluorescence microscopy and qRT-PCR Increased hemoglobin levels in CKD mice and downregulated the infiltration of F4/80-positive macrophages [133]
Vitro: MDCK, PMC, HK-2, normal
BMSCs (Human) AKI Vivo: SCID, glycerol Electroporation QRT-PCR Reduced the amount of exosomes required for treatment, alleviated tubular necrosis and hyaline tubular formation [134]
Vitro: TECs, H/R
UCMSCs (Human) DN, CKD Vivo: C57BL/6, STZ Electroporation UV–spectrophotometry Induced CD4+Treg cells to regulate intestinal microbiota metabolism to reduce kidney injury [135]
Orange IgAN Vivo: BALB/c, SEB, BSA Electroporation UV-spectrophotometry Reduced proteinuria, alleviated mesangial hyperplasia and IgA deposition, and decreased the percentage of LIGHT+CD4+ cells [136]
Vitro: PPs, ConA, IL-2
ToMCSs (Human) CKD Vivo: ICR, 5/6 nephrectomy CRISPR-Cas9 system Thermogravimetric analysis Engineered exosomes promote stem cell migration and tubule and blood vessel generation by targeting CXCR4 [137]

Abbreviations: ConA, concanavalin A; EDL, extensor digitorum longus; EndoMT, endothelial-to-mesenchymal transition; eNOS, endothelial nitric oxide synthase; ERCs, endometrial regenerative cells; IgAN, immunoglobulin A nephropathy; KMSCs, kidney mesenchymal stem cells; LTH, linear tubular homing peptide; NMR, nuclear magnetic resonance; PMC, peritoneal mesothelial cells; PPs, peyer’s patches; qRT-PCR, quantitative real-time polymerase chain reaction; RBCs, red blood cells; R-Exos, RBCs-exosomes; RGD, arginine-glycine-aspartic acid peptide; SEB, staphylococcal enterotoxin B; ToMCSs, tonsil mesenchymal stem cells; UV-Vis, ultraviolet-visible spectrophotometry.