title: Umbilical cord mesenchymal stem cells derived extracellular vesicles can safely ameliorate the progression of chronic kidney diseases.
abstract: BACKGROUND
  Bio-products from stem/progenitor cells, such as extracellular vesicles, are likely a new promising approach for reprogramming resident cells in both acute and chronic kidney disease. Forty CKD patients stage III and IV (eGFR 15-60 mg/ml) have been divided into two groups; twenty patients as treatment group "A" and twenty patients as a matching placebo group "B". Two doses of MSC-derived extracellular vesicles had been administered to patients of group "A". Blood urea, serum creatinine, urinary albumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) have been used to assess kidney functions and TNF-α, TGF-β1 and IL-10 have been used to assess the amelioration of the inflammatory immune activity.
  
  
  RESULTS
  Participants in group A exhibited significant improvement of eGFR, serum creatinine level, blood urea and UACR. Patients of the treatment group "A" also exhibited significant increase in plasma levels of TGF-β1, and IL-10 and significant decrease in plasma levels of TNF-α. Participants of the control group B did not show significant improvement in any of the previously mentioned parameters at any time point of the study period.
  
  
  CONCLUSIONS
  Administration of cell-free cord-blood mesenchymal stem cells derived extracellular vesicles (CF-CB-MSCs-EVs) is safe and can ameliorate the inflammatory immune reaction and improve the overall kidney function in grade III-IV CKD patients.
authors: Department of Internal Medicine, Nephrology Section, Sahel Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, Egypt ; Department of Internal medicine, Nephrology Section, Faculty of Medicine, October Six University, Cairo, Egypt.
authors: Wael
authors: 0000-0001-8603-3169
authors: W
authors: Nassar
authors: Department of clinical pathology, stem cells Section, Faculty of medicine, Cairo University, Cairo, Egypt.
authors: Mervat
authors: M
authors: El-Ansary
authors: Department of Biochemistry, Faculty of medicine, Cairo University, Cairo, Egypt.
authors: Dina
authors: D
authors: Sabry
authors: Department of Internal medicine, Nephrology Section, Faculty of Medicine, October Six University, Cairo, Egypt.
authors: Mostafa A
authors: MA
authors: Mostafa
authors: Department of Internal Medicine, Nephrology Section, Faculty of medicine, Cairo University, Cairo, Egypt.
authors: Tarek
authors: T
authors: Fayad
authors: Department of Internal medicine, Nephrology Section, Faculty of Medicine, October Six University, Cairo, Egypt.
authors: Esam
authors: E
authors: Kotb
authors: Department of Internal Medicine, Nephrology Section, Sahel Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, Egypt.
authors: Mahmoud
authors: M
authors: Temraz
authors: Department of Internal Medicine, Nephrology Section, Sahel Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, Egypt.
authors: Abdel-Naser
authors: AN
authors: Saad
authors: Department of Internal Medicine, Nephrology Section, Sahel Teaching Hospital, General Organization of Teaching Hospitals and Institutes (GOTHI), Cairo, Egypt.
authors: Wael
authors: W
authors: Essa
authors: Department of clinical pathology, stem cells Section, Faculty of medicine, Cairo University, Cairo, Egypt.
authors: Heba
authors: H
authors: Adel
keywords: Chronic kidney disease; Extracellular vesicles; Mesenchymal stem cells; Microvesicles