BACKGROUND: Chronic kidney disease (CKD) is a progressive disorder that leads to significant structural and functional changes in the kidneys, posing a major global health concern and contributing to high mortality rates. METHODS: The urgent need for innovative treatments is evident. Mesenchymal stem cells (MSCs) are well-regarded in regenerative medicine for their ability to repair tissue and modulate immune responses. Emerging research indicates that the therapeutic benefits of MSCs are largely mediated by the secretion of extracellular vesicles (EVs), particularly exosomes (MSC-Exos), which replicate the effects of MSCs by delivering genetic materials and proteins to target cells. RESULTS: MSC-Exos are novel natural carriers for targeted gene or drug delivery, offering biocompatibility, intrinsic targeting capabilities, and bioactive cargo to modulate recipient cells. They represent a groundbreaking platform for precision medicine, enhancing therapeutic efficacy with minimal immunogenicity and off-target effects. Moreover, embedding exosomes within hydrogels has emerged as a promising strategy to maintain their biological activity and enable a controlled release. CONCLUSION This review explores the roles of MSC-Exos in CKD pathophysiology, highlights the renoprotective effects of MSC-Exos for various sources, and provides a comprehensive overview of how hydrogel biomaterials present a promising approach for integrating exosomes to enhance therapeutic outcomes. The use of hydrogels to encapsulate exosomes improves their sustained release and stability in diseased kidney tissues, providing an innovative strategy to enhance precision therapies.

BACKGROUND: Extracellular vesicles (EVs) are derived from internal cellular compartments, and have potential as a diagnostic and therapeutic tool in degenerative disease associated with aging. Mesenchymal stem cells (MSCs) have become a promising tool for functional EVs production. This study investigated the efficacy of EVs and its effect on differentiation capacity. METHODS: The characteristics of MSCs were evaluated by flow cytometry and stem cell differentiation analysis, and a production mode of functional EVs was scaled from MSCs. The concentration and size of EVs were quantitated by Nanoparticle Tracking Analysis (NTA). Western blot analysis was used to assess the protein expression of exosomespecific markers. The effects of MSC-derived EVs were assessed by chondrogenic and adipogenic differentiation analyses and histological observation. RESULTS The range of the particle size of adipose-derived stem cells (ADSCs)- and Wharton’s jelly -MSCs-derived EVs were from 130 to 150 nm as measured by NTA, which showed positive expression of exosomal markers. The chondrogenic induction ability was weakened in the absence of EVs in vitro. Interestingly, after EV administration, type II collagen, a major component in the cartilage extracellular matrix, was upregulated compared to the EV-free condition.Moreover, EVs decreased the lipid accumulation rate during adipogenic induction.