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CD5L-engineered exosomes (also known as CD5L-enriched FRC-Exos) are engineered extracellular vesicles (EVs) derived from fibroblastic reticular cells (FRCs) or CD5L-overexpressing cells, modified to deliver the anti-inflammatory and metabolic regulatory protein CD5L (CD5 antigen-like). These exosomes are further functionalized with a kidney-targeting LTH peptide, which binds to kidney injury molecule-1 (KIM-1/HAVCR1) on injured renal tubular cells. Developed by researchers at Zhongnan Hospital of Wuhan University, this therapeutic candidate is designed to treat sepsis-associated acute kidney injury (S-AKI). Mechanistically, the delivered CD5L interacts with fatty acid synthase (FASN) to inhibit fatty acid synthesis and promote fatty acid oxidation (FAO), thereby restoring mitochondrial bioenergetics and homeostasis. Additionally, the treatment promotes PINK1-Parkin-mediated mitophagy, inhibits NLRP3 inflammasome activation, and reduces tubular cell pyroptosis.
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