Functional and potency assays for mesenchymal stromal cell–extracellular vesicles in kidney disease

Kidney diseases pose a significant challenge, lacking effective therapies. Extracellular vesicle (EV)-based therapies have emerged as a novel advanced therapeutic. Particularly, mesenchymal stromal cells (MSC) and their EV are being explored as potential candidates. While MSC-EV therapeutics offer promise, there is a lack of widely standardized potency tests to assess EV effectiveness. Tailoring potency assessment in kidney diseases requires considering multifactorial effects and may necessitate a combination of multiple assays to recapitulate EV function. The design of a matrix of assays will be specific for the chosen disease and will involve specific molecular mechanisms and biological processes. This review highlights recent MSC-EV functional assays focused on modeling kidney disease mechanisms of action.