Urinary Extracellular Vesicles Carrying Klotho Improve the Recovery of Renal Function in an Acute Tubular Injury Model

Cristina Grange, Elli Papadimitriou, Veronica Dimuccio, Cecilia Pastorino, Jordi Molina, Ryan O'Kelly, Laura J. Niedernhofer, Paul D. Robbins, Giovanni Camussi, Benedetta Bussolati

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Acute kidney injury, defined by a rapid deterioration of renal function, is a common complication in hospitalized patients. Among the recent therapeutic options, the use of extracellular vesicles (EVs) is considered a promising strategy. Here we propose a possible therapeutic use of renal-derived EVs isolated from normal urine (urine-derived EVs [uEVs]) in a murine model of acute injury generated by glycerol injection. uEVs accelerated renal recovery, stimulating tubular cell proliferation, reducing the expression of inflammatory and injury markers, and restoring endogenous Klotho loss. When intravenously injected, labeled uEVs localized within injured kidneys and transferred their microRNA cargo. Moreover, uEVs contained the reno-protective Klotho molecule. Murine uEVs derived from Klotho null mice lost the reno-protective effect observed using murine EVs from wild-type mice. This was regained when Klotho-negative murine uEVs were reconstituted with recombinant Klotho. Similarly, ineffective fibroblast EVs acquired reno-protection when engineered with human recombinant Klotho. Our results reveal a novel potential use of uEVs as a new therapeutic strategy for acute kidney injury, highlighting the presence and role of the reno-protective factor Klotho.

Original languageEnglish (US)
Pages (from-to)490-502
Number of pages13
JournalMolecular Therapy
Issue number2
StatePublished - Feb 5 2020

Bibliographical note

Funding Information:
We acknowledge funding from FP7 Marie Curie NephroTools ITN project and Miur ex60% (to B.B.) and NIH grant AG4059675 (to P.D.R.). We also acknowledge the technical support of Dr. Antico for histology and of Dr. Deregibus for electron microscopy.


  • AKI
  • Klotho
  • damage
  • engineering
  • injury markers
  • mesenchymal stem cells
  • microRNAs
  • renal regeneration
  • urinary exosomes
  • vesicles

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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