Exosomes as Vascular Biomarkers for Diabetic Heart Disease and Diabetic Nephropathy

Exosomes are microvesicles that constitute a non-classical mechanism for protein secretion, and they represent a sub-proteome, thus assisting in the difficult task of biomarker discovery in a biological fluid as urine, plasma, or serum. Exosomes have a proven role in regulating immune response, antigen presentation, RNA and protein transfer, and cell-cell (organ–organ) interaction/signaling. The potential role of exosomes in the cardio-renal syndromeCardio-renal syndrome currently remains underexplored. Cardiovascular pathologiesCardiovascular pathologies continue to be the leading cause of morbidity and mortality worldwide, and, particularly, rates of cardiovascular events and death consistently increase as kidney function worsens. In other words, chronic kidney disease (CKD)Chronic kidney disease (CKD) acts as a risk multiplier. This could be compounded by other metabolic dysfunction entities, such as diabetes, pre-diabetes, or overweight/obesity. Unfortunately, the relationship between markers of cardio-metabolic risk in kidney pathology often differs from that in the general population. Efforts are underway to search for the novel mechanism of action simultaneously operating in both pathologies. This book chapter will focus on the role of exosomes in cardiovascular and renal diseasesRenal disease in search for novel key targets of interaction between vascular disease and the kidneys.