[1] Microvesicles have protein content similar to the plasma membrane of activated platelets and have procoagulant and inflammatory functions.[79, 80] In contrast, platelet exosomes only interact poorly with annexin-V and do not bind prothrombin and factor X. Platelet-derived exosomes are enriched in CD63, a tetraspanin protein also found on exosomes from other cell types.[81] Tetraspanin proteins have been implicated in adhesive as well as co-stimulatory and signalling functions. Platelet-derived exosomes may be released at

sites of vascular injury and could well Rapamycin function in promotion of platelet and neutrophil adhesion.[1, 82] Endothelial dysfunction and vascular calcification is a significant risk factor for cardiovascular morbidity and mortality in patients with renal disease. In vitro, vesicles appear to be important in mediating vascular smooth muscle cell calcification.[83] In a recent study, it was found that phosphorylated fetuin-A is present in the calciprotein particles in serum of predialysis chronic kidney disease (CKD) patients. Increased calciprotein particle fetuin-A levels reflect an increasingly procalcific milieu and are associated with increased aortic stiffness.[84] Increased levels of circulating microparticles

(MP) or microvesicles check details have been detected in patients with CKD. Circulating levels of MP and microvesicles derived from endothelial cells correlate with arterial stiffness in haemodialysis

patients.[85-87] It is unclear whether exosomes and/or other circulating MP may play an important role in transporting or promoting vascular calcification in CKD or in other calcification-associated Selleckchem Ixazomib diseases. Nephrolithiasis is associated with the formation of calcium oxalate, calcium phosphate, cystine, struvite or urate crystals in the kidneys. In vitro studies have demonstrated that renal brush border-derived exosomes/microvesicles of ∼100 nm in diameter can induce and promote calcium oxalate crystallization in nephrolithiasis.[88] In transplantation, it has been shown that the exchange of exosomes between dendritic cells may constitute a potential mechanism by which passenger leukocytes transfer alloantigens to recipient antigen-presenting cells, leading to an increased generation of donor-reactive T cells.[89] On the other hand, other studies have found that dendritic cell-derived exosomes may induce tolerance rather than immune stimulation.[90] Engineering of dendritic cells to release tolerogenic exosomes could be useful to prevent/ameliorate transplant rejection. Urine is the ideal biological sample for discovery of new biomarkers for kidney diseases because of the ease of non-invasive collection.