Extracellular vesicles and their role in Lupus Nephritis: A scoping review

Lupus nephritis (LN) is one of the most severe and common complications of systemic lupus erythematosus (SLE), which pathogenesis is mainly driven by immune complex deposition and infiltration of immune cells, ultimately leading to progressive renal damage. Extracellular vesicles (EVs) are nanometer-sized particles released by almost all cell types that mediate intercellular communication and modulate diverse biological processes, including immune activation, through the transfer of vesicular cargo. Increasing evidence shows that EVs contribute significantly to the pathogenesis of LN, mediating processes such as antigen presentation, stimulating inflammatory cytokine production and facilitating immune complex deposition, among other mechanisms. Following this line of thought, EVs represent a promising source of specific biomarkers for early diagnosis, monitoring of disease activity and even development of therapeutic targets. This review focuses on summarizing the most recent findings on the role of EVs in LN pathophysiology, diagnosis, monitoring, and their potential for the development of therapeutic solutions.