Pathophysiological features of reparative processes in adjuvant therapy of renal tuberculosis with extracellular vesicles in an experiment

Abstract

Currently, various studies are focusing on the potential of stem cells as adjuvant therapy for tuberculosis. In addition, there is significant interest in the use of extracellular vesicles (EVs), since compared with whole-cell therapy, EVs derived from mesenchymal stromal cells (MSCs) have many advantages such as good tolerability, low immunogenicity, no risk of malignancy, more stable membrane structure than MSCs, etc. These advantages open up broad prospects for the treatment of a large number of diseases. In the present study, we investigated the protein composition of extracellular vesicles and assessed their therapeutic potential in a rabbit model of renal tuberculosis in combination with standard anti-TB treatment. Materials and methods. The study involved 20 rabbits with renal tuberculosis, which were intravenously injected with extracellular vesicles isolated from mesenchymal stem cells. Therapeutic efficacy was assessed by analyzing changes in the level of anti- and pro-inflammatory cytokines, as well as by computed tomography of the kidneys with subsequent histological and morphometric examination. The protein composition of extracellular vesicles was determined using liquid chromatography and mass spectrometry. Results. The addition of extracellular vesicles to standard anti-tuberculosis treatment resulted in a statistically significant increase in anti-inflammatory cytokines and a decrease in pro-inflammatory cytokines, as well as a significant decrease in the area of ??specific inflammation compared to groups with standard treatment, which was largely due to the proteins included in the extracellular vesicles. Conclusion. The use of extracellular vesicles as a component of complex anti-tuberculosis therapy increases the effectiveness of renal tuberculosis treatment by accelerating reparative processes in the area of specific inflammation.