Fig. 2.

Pathways of autophagy in podocyte for: There are four best known pathways of autophagy in podocyte, with the mechanistic target of rapamycin(mTOR), AMPK, SIRT and PI3K/Akt. Autophagy is suppressed by the activation of mTOR1, activation of AMPK can restrain activation of mTOR1 and activate the autophagy. PI3K/Akt can suppress the autophagy via Rheb to enhance the mTOR1 pathway, the suppression of AMPK and SIRT1 further impairs autophagy in various kidney disease. ① Circulating platelet microparticles was associated with endothelial cells autophagy by the activation of mTORC pathways; ② Mesenchymal stem cell (MSC)-derived exosomes reduced the expression of phosphorylated mTOR/mTOR and enhance the expression of AMPK; ③ Adipose tissue-derived mesenchymal stem cells (AtMSC) derived exosomes had renoprotective functions via the regulation of NF-κB activities through SIRT1; ④ Exosomal miR-30la-3p may play an important role in promoting cellar autophagy via inhibit the expression of PTEN and activate the PI3K/AKT pathway and exosomal miR-10b may targeting and inhibiting the PI3K/Akt/mTOR pathway