Exosomes from high glucose-treated glomerular endothelial cells activate mesangial cells to promote renal fibrosis

The interaction between glomerular endothelial cells (GECs) and glomerular mesangial cells (GMCs) is an essential aspect of diabetic nephropathy (DN). Therefore, understanding how GECs communicate with GMCs in the diabetic environment is crucial for the development of new targets for the prevention and treatment of DN. Exosomes, nanometer-sized extracellular membrane vesicles secreted by various cell types, play important roles in cell-to-cell communication via the transfer of mRNA, microRNA and protein. In this study, we demonstrate that high glucose (HG)-treated GECs secrete a higher number of exosomes highly enriched in TGF-beta 1 mRNA compared with normal glucose (NG)-treated GECs. Exosomes released by HG-treated GECs can promote alpha-smooth muscle actin (alpha-SMA) expression, proliferation and extracellular matrix protein overproduction in GMCs through the TGF-beta 1/Smad3 signaling pathway. Thus, we provide new insights into the pathogenesis of DN that involves intercellular transfer of TGF-beta 1 mRNA in the GEC-to-GMC direction via exosomes.