Quantitative and Qualitative Parameters of DCE-MRI Predict CDKN2A/B Homozygous Deletion in Gliomas.

RATIONALE AND OBJECTIVES: Homozygous deletion (HD) of CDKN2A/B holds important prognostic value in gliomas. This study aimed to explore the predictive potential of conventional MRI characteristics combined with dynamic contrast-enhanced MRI parameters in predicting CDKN2A/B HD status in gliomas. MATERIALS AND METHODS: Preoperative MRI data of 105 patients (69 without CDKN2A/B HD, and 36 with CDKN2A/B homozygous deletion) with gliomas were retrospectively collected. Conventional MRI features and dynamic contrast-enhanced-MRI qualitative parameter time-intensity curve type, quantitative parameters Ktrans, Kep, Ve, Vp, and iAUC were obtained. Logistic regression models for prediction of CDKN2A/B HD status were constructed in all types of gliomas and both subtypes of IDH-mutant and IDH-wild gliomas. RESULTS: Multivariate analysis for all patients demonstrated that age (OR=1.103, p = 0.002) and Ktrans (OR=1.051, p < 0.001) independently predicted CDKN2A/B HD. In IDH-mutant subgroup, multivariate analysis results indicated that Ktrans (OR=1.098, p = 0.031) emerged as autonomous predictors of CDKN2A/B HD. In IDH-wild subgroup, age (OR=1.111, p = 0.002) and Ktrans (OR=1.032, p = 0.001) were independent predictors of CDKN2A/B HD according to the multivariate analysis. The areas under the receiver operating characteristic curve of the corresponding models were 0.90, 0.95 and 0.84, respectively. CONCLUSION: Ktrans can serve as valuable predictive parameters for identifying CDKN2A/B HD status in all types of gliomas and both subtypes of IDH-mutant and IDH-wild gliomas. These findings provide a foundation for precise preoperative non-invasive diagnosis and personalized treatment approaches for glioma patients.

Factors affecting local alveolar bone thickness in unilateral maxillary canine-lateral incisor transposition.

INTRODUCTION: This study aimed to use 3-dimensional data to investigate the factors affecting local alveolar bone thickness in unilateral maxillary canine-lateral incisor transposition. METHODS: Pretreatment cone-beam computed tomography data of 34 patients with unilateral maxillary canine-lateral transposition were imported into Dolphin Imaging software (version 11.8; Dolphin Imaging and Management Solutions, Chatsworth, Calif) for 3-dimensional reconstruction. The age, gender, and type of transposition at the beginning of treatment were recorded. The thickness and height of the transposed canine, the labiopalatal and distomedial distance from the transposed canine to the apex of the lateral incisor, the inclination of the transposed lateral incisor, the apical height of the lateral incisor, and the alveolar bone thickness in the apical plane were measured. Multiple linear regression analyses were applied to investigate the factors affecting alveolar bone thickness in the apical plane of the transposed lateral incisor. Two sample t test were applied to assess the difference of alveolar bone thickness in patients of different ages. RESULTS: The 10 boys and 24 girls had a mean age of 12.26 ± 2.34 years. In all 34 participants, the apical alveolar bone thickness of transposed lateral incisors was significantly higher than that of the unaffected side (P <0.05). Based on multiple regression analyses, factors associated with a wider alveolar bone thickness were as follows: age (ß = -0.237; P = 0.008), the labiopalatal distance from the transposed canine to the apex of the lateral incisor (ß = 0.675; P <0.001), and the inclination of the transposed lateral incisor (ß = 0.048; P = 0.032). Patients aged <11 years had significantly thicker alveolar bone than that of patients aged >11 years (P <0.05). CONCLUSIONS: Patients with younger age, greater lateral incisor inclination, and greater labiopalatal distance between canine and lateral incisor had more alveolar bone thickness. Early treatment permits tooth movement within the thicker alveolar bone.

Th9/IL-9 may participate in the pathogenesis of multiple myeloma.

INTRODUCTION: This research is aimed to evaluate the correlation between Th9-associated cytokine levels in MM patients, clinical features, and therapy. METHODS: Peripheral blood samples were taken in 52 MM patients and 20 healthy volunteers matched by sex and age. The patients with MM were separated into two groups: the untreated group (27) and the remission group (25). An enzyme-linked immunosorbent assay (ELISA) was used to measure the IL-9 plasma levels. The levels of Th9-associated cytokines' mRNA expression (IL-9, PU.1, and IRF4) were measured in RT-qPCR. We also analyzed the correlations between the IL-9 plasma levels and the clinical parameters of newly diagnosed MM patients. RESULTS: The IL-9 plasma levels and the Th9-associated cytokines (IL-9, PU.1, and IRF4) mRNA levels in newly diagnosed MM patients were significantly elevated than those in healthy volunteers and significantly decreased after achieving remission. Moreover, PU.1 and IRF4 had a positive correlation with the IL-9 mRNA expression. Then, we found that the upregulation of IL-9 plasma levels correlates with the severity of anemia and decreased albumin Levels. CONCLUSION: The results demonstrate that Th9/IL-9 may be involved in the pathogenesis of MM and is correlated with worse patient conditions such as lower hemoglobin and serum albumin. More work is necessary to confirm whether they might serve as a useful therapeutic target and prognostic marker for MM.

Metal-Phenolic Network with Pd Nanoparticle Nodes Synergizes Oxidase-Like and Photothermal Properties to Eradicate Oral Polymicrobial Biofilm-Associated Infections.

Designing an effective treatment strategy to combat oral diseases caused by complex polymicrobial biofilms remains a great challenge. Herein, a series of metal-phenolic network with Pd nanoparticle nodes using polyphenols as stabilizers and reducing agents is constructed. Among them, sulfonated lignin-Pd (SLS-Pd) with ultrafine size palladium nanoparticles and broadband near infrared absorption exhibit excellent oxidase-like activity and stable photothermal effect. In vitro experiments demonstrate that the superoxide radical generated by SLS-Pd oxidase-like activity exhibits selective antibacterial effects, while its photothermal effect induced hyperthermia exhibits potent antifungal properties. This difference is further elucidated by RNA-sequencing analysis and all-atom simulation. Moreover, the SLS-Pd-mediated synergistic antimicrobial system exhibits remarkable efficacy in combating various biofilms and polymicrobial biofilms. By establishing a root canal model and an oropharyngeal candidiasis model, the feasibility of the synergistic antimicrobial system in treating oral biofilm-related infections is further validated. This system provides a promising therapeutic approach for polymicrobial biofilm-associated infections in the oral cavity.

Aflibercept Loaded Eye-Drop Hydrogel Mediated with Cell-Penetrating Peptide for Corneal Neovascularization Treatment.

Corneal neovascularization (CoNV) is a major cause of visual impairment worldwide. Currently, available treatment options have limited efficacy and are associated with adverse effects due to biological barriers and clearance mechanisms. To address this challenge, a novel topical delivery system is developed-Gel 2_1&Eylea-an aflibercept-loaded eye-drop hydrogel mediated with cell-penetrating peptide 1. Gel 2_1&Eylea demonstrates superior membrane permeability, increased stability, and prolonged drug retention time on the ocular surface, and thus may improve drug efficacy. In a rabbit CoNV model, Gel 2_1&Eylea significantly reduces the density of neovascularization with no adverse effects on normal corneoscleral limbal vessels, demonstrating high efficacy and biocompatibility. This work identifies a promising treatment for CoNV which has the potential to benefit other ocular neovascular diseases.

Development and validation of prognostic nomogram for elderly patients with clear cell renal cell carcinoma based on the SEER database.

This study sought to establish nomogram models of overall survival (OS) in patients with elderly clear cell renal cell carcinoma (ECCRCC). The Surveillance, Epidemiology, and End Results database provided data of the ECCRCC-afflicted patients diagnosed during the period from 2010 to 2015. This data was subsequently segregated into the training and validation sets randomly in a 7:3 ratio. The calibration curves, the receiver operating characteristic curves, the decision curve analysis and the Concordance index (C-index) were applied for the model evaluation. 9201 eligible cases from 2010 to 2015 were extracted; 6441 were included in the training cohort and 2760 in the validation cohort. The C-index for the training and validation sets were 0.710 and 0.709, respectively. The receiver operating characteristic and decision curve analysis curves demonstrated that nomograms outperformed the AJCC stage in predictive performance. Moreover, the nomogram was found to match closely with the actual observation, as indicated by the calibration plots. To make predictions with regard to the survival of the ECCRCC-afflicted individuals, and as a guide for treatment, the new nomogram could be used.

Morphometric evaluation of alveolar bone after orthodontic treatment of multiple impacted teeth in the unilateral maxillary anterior region.

INTRODUCTION: This study aimed to investigate the height and thickness of alveolar bone by cone-beam computed tomography imaging after orthodontic treatment in the unilateral maxillary anterior region and speculate on reasons for the difference in alveolar bone morphology. METHODS: This study selected 11 patients (3 males and 8 females; mean age, 9.42 ± 1.45 years). Cone-beam computed tomography was performed for these 11 patients before and after treatment using Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). Labial and palatal alveolar bone thickness (BT) at root apices and different levels along the roots and loss of alveolar bone height was measured for each impacted tooth and its contralateral homonymous tooth. RESULTS: After orthodontic therapy, all 3 impacted anterior teeth had different degrees of loss of labial alveolar bone height compared with the normal side (central incisor: -1.5 mm, P <0.005; lateral incisor: -1.06 mm, P <0.01; canine: -0.59 mm, P < 0.01). The lateral incisors also showed palatal alveolar bone height loss compared with the unaffected side (-0.8 mm, P <0.005). Alveolar BT at root apices of impacted canines was 1.14 mm thicker than the normal side (P <0.005). Central and lateral incisors were similar to the normal side. The thickness of the alveolar bone at 8, 10, and 12 mm of the impacted canine position was still larger than that on the healthy side, whereas the difference in average thickness between the healthy and affected side had been significantly reduced compared with pretreatment measurements. CONCLUSIONS: There is satisfactory retention of alveolar bone height in canines after orthodontic treatment; however, alveolar bone loss is slightly worse at central and lateral incisors. Retention of alveolar BT was normal for impacted anterior teeth, whereas excess apical alveolar BT at the canines, although still present, was substantially less significant than had been observed before treatment.

Supramolecular Photothermal Cascade Nano-Reactor Enables Photothermal Effect, Cascade Reaction, and In Situ Hydrogelation for Biofilm-Associated Tooth-Extraction Wound Healing.

Due to the emergence of drug resistance in bacteria and biofilm protection, achieving a satisfactory therapeutic effect for bacteria-infected open wounds with conventional measures is problematic. Here, a photothermal cascade nano-reactor (CPNC@GOx-Fe2+ ) is constructed through a supramolecular strategy through hydrogen bonding and coordination interactions between chitosan-modified palladium nano-cube (CPNC), glucose oxidase (GOx), and ferrous iron (Fe2+ ). CPNC@GOx-Fe2+ exhibits excellent photothermal effects and powers the GOx-assisted cascade reaction to generate hydroxyl radicals, enabling photothermal and chemodynamic combination therapy against bacteria and biofilms. Further proteomics, metabolomics, and all-atom simulation results indicate that the damage of the hydroxyl radical to the function and structure of the cell membrane and the thermal effect enhance the fluidity and inhomogeneity of the bacterial cell membrane, resulting in the synergistic antibacterial effect. In the biofilm-associated tooth extraction wound model, the hydroxyl radical generated from the cascade reaction process can initiate the radical polymerization process to form a hydrogel in situ for wound protection. In vivo experiments confirm that synergistic antibacterial and wound protection can accelerate the healing of infected tooth-extraction wounds without affecting the oral commensal microbiota. This study provides a way to propose a multifunctional supramolecular system for the treatment of open wound infection.

Thermal analysis technology to utilize waste biomass and waste heat to produce high-quality combustible gas through simulations and experiments.

To ensure the proper utilization of waste biomass (WB) and high-temperature waste heat, this study proposes a new method for obtaining gaseous fuels by pyrolyzing WB and using waste heat in the converter vaporization cooling flue (CVCF). This study is theoretically based on the simulation software Factsage 6.1 and the release patterns of the gaseous products including CO, H2, CH4 and CO2 obtained from waste biomass, were studied at different temperatures and pressures. Thermogravimetric-mass spectrometer (TG-MS) was used to investigate the pyrolysis of WB at heating rates of 5, 10, 15, and 20 °C/min from room temperature to 1400 °C. Kinetics parameters were calculated by using the Flynn-Wall-Ozawa (FWO) and Kissinger-Akahira-Sunose (KAS) models. To investigate the effects of temperature, a settling furnace was also used to simulate CVCF. Thermal decomposition produced the primary gases namely CO, CH4, and H2. Pyrolysis had an average activation energy of 183.29 kJ/mol. As the temperature increased from 800 °C to 1200 °C, the CO content increased from 39.7 % to 48.9 % and the H2 content increased from 35 % to 45.1 %. As the temperature rose from 800 to 1200 °C, the lower heating value (LHV) increased from 11.38 to 12.05 MJ/Nm3. The findings primarily confirmed the feasibility of injecting biomass into the CVCF to generate gaseous fuels from waste heat.

Neighboring Carboxylic Acid Boosts Peroxidase-Like Property of Metal-Phenolic Nano-Networks in Eradicating Streptococcus mutans Biofilms.

Developing nature-inspired nanomaterials with enzymatic activity is essential in combating bacterial biofilms. Here, it is reported that incorporating the carboxylic acid in phenolic/Fe nano-networks can efficiently manipulate their peroxidase-like activity via the acidic microenvironment and neighboring effect of the carboxyl group. The optimal gallic acid/Fe (GA/Fe) nano-networks demonstrate highly enzymatic activity in catalyzing H2 O2 into oxidative radicals, damaging the cell membrane and extracellular DNA in Streptococcus mutans biofilms. Theoretical calculation suggests that the neighboring carboxyl group can aid the H2 O2 adsorption, free radical generation, and catalyst reactivation, resulting in superb catalytic efficiency. Further all-atom simulation suggests the peroxidation of lipids can increase the cell membrane fluidity and permeability. Also, GA/Fe nano-networks show great potential in inhibiting tooth decay and treating other biofilm-associated diseases without affecting the commensal oral flora. This strategy provides a facile and scale-up way to prepare the enzyme-like materials and manipulate their enzymatic activity for biomedical applications.

Dynamic changes and prognosis of pulmonary congestion by lung ultrasound in hemodialysis patients: a systematic review and meta-analysis.

AIMS: Lung ultrasound (LUS) has been rapidly developed to evaluate pulmonary extravascular fluid. A systematic review was conducted to study the dynamic changes of LUS findings of pulmonary congestion before and after hemodialysis and examine the application of LUS for the prognosis of hemodialysis patients. MATERIAL AND METHODS: This study searched online databases for articles on hemodialysis patients that used LUS to evaluate dynamic changes during hemodialysis or prognosis. Articles published in English or Chinese until September 2021 with ≥30 patients were included in this study. RESULTS: Of the 1329 articles, 14 met the inclusion criteria: 9 reported dynamic changes during dialysis in LUS (438 patients), and 5 reported the prognosis of hemodialysis patients in LUS (1274 patients). As indicated by a further meta-analysis, eight studies found that the combined standardized effect size was -0.74. The all-cause mortality rate of the dialysis patient group with high B-line scores was three times that of the dialysis patient group with low B-line scores. In dialysis patients, no difference was found between the LUS guided treatment and the conventional care in reducing the all-cause mortality (HR=0.92 95%CI: 0.67-1.27) and cardiovascular events (HR=0.98 95%CI: 0.72 -1.34). CONCLUSIONS: LUS can be used to effectively evaluate the volume status of hemodialysis patients in real time. The level of B-line before dialysis is significantly correlated with the poor prognosis. However, compared with the routine nursing group, the treatment of hemodialysis patients with LUS-guided volume management cannot effectively reduce mortality and cardiovascular events.

Basic psychological need satisfaction and well-being for gig workers: a fuzzy set QCA approach in DiDi of China.

With the rapid development of the gig economy, the psychological needs of gig workers have gradually attracted attention. The purpose of the study is to explore the relationship between basic psychological need and well-being. Fuzzy-set qualitative comparative analysis (fsQCA) was used to analyze questionnaire data from a sample of 422 DiDi drivers in China. The results show that there are altogether 10 basic psychological need satisfaction combination configurations to improve the well-being of gig workers. In general, Chinese gig workers pay more attention to whether respect and recognition, and occupational planning are met. This study contributes to the literature of basic psychological need and gig workers' well-being in the Chinese context. In the analysis of asymmetric relationship, it has some noticeable advantages, because it allows to explore how basic psychological needs are combined with the necessary and sufficient conditions, so as to form the basis for the well-being of gig workers. It represents a promising new direction for gig workers' well-being.

An efficient differential sensing strategy for phenolic pollutants based on a nanozyme with polyphenol oxidase activity.

To realize the efficient differential sensing of phenolic pollutants in sewage, a novel sensing strategy was successfully developed based on a nanozyme (GMP-Cu) with polyphenol oxidase activity. Phenolic pollutants can be oxidized using GMP-Cu, and the oxidation products reacts subsequently with 4-aminoantipyrine to produce a quinone-imine compound. The absorption spectra of final quinone-imine products that resulted from different phenolic pollutants showed obvious differences, which were due to the interaction difference between GMP-Cu and phenolic pollutants, as well as the different molecular structures of the quinone-imine products from different phenolic pollutants. Based on the difference in the absorption spectra, a novel differential sensing strategy was developed. A genetic algorithm was used to select the characteristic wavelengths at different enzymatic reaction times. Hierarchical cluster analysis and PLS-DA algorithms were utilized for the discriminant sensing of seven representative phenolic pollutants, including hydroquinone, resorcinol, catechol, resorcinol, phenol, p-chlorophenol, and 2,4-dichlorophenol. A scientific wavelength selection algorithm and a recognition algorithm resulted in the successful identification of phenolic pollutants in sewage with a discriminant accuracy of 100%, and differentiation of the phenolic pollutants regardless of their concentration. These results indicated that a sensing strategy can be used as an effective tool for the efficient identification and differentiation of phenolic pollutants in sewage.

Evaluation of polluted urban river water quality: a case study of the Xunsi River watershed, China.

Urbanization has caused severe negative impacts on intra-urban river water bodies. In this paper, 22 physicochemical parameters were measured at 20 locations in the level period and 29 locations in the wet and dry period using nearby urban area surface water samples from a medium-sized polluted river (a lake-river continuum, i.e., Xunsi River, Qingling River and Tangxun Lake) in the Yangtze River watershed in Wuhan, China. In this study, the environmental quality standards for surface water of China (GB3838-2002) and the WHO drinking water standard (2011) were used as reference standards. After the basic physicochemical parameters were evaluated, the possible sources of pollution in the study area under urban pressure were examined by applying multivariate statistical techniques. The factor analysis method and entropy weighting method identified three critical factors describing the type of surface water pollution in the watershed: (1) pollution from nutrients, mainly nitrogen pollution, (2) trace metals pollution, mainly from Fe and Pb, and (3) organic pollution. Based on multivariate analysis, the weighted arithmetic water quality index (WQI) was used to assess the water quality of each period. The WQI results show that the water near the urban area of the watershed temporally shows light to moderate pollution overall in the level and wet periods, and sever pollution in the dry period. The worst water quality indicating water that is not suitable for any practical use occurs in the dry period. Spatially distributed in clusters and strips visualized in kriging method, the water quality of the lake source and upstream is better than that of the downstream. In addition, Escherichia coli was detected at consistently high levels, and although the river is not a source of drinking water, it could pose a threat to downstream waterworks.

Deletion and tandem duplications of biosynthetic genes drive the diversity of triterpenoids in Aralia elata.

Araliaceae species produce various classes of triterpene and triterpenoid saponins, such as the oleanane-type triterpenoids in Aralia species and dammarane-type saponins in Panax, valued for their medicinal properties. The lack of genome sequences of Panax relatives has hindered mechanistic insight into the divergence of triterpene saponins in Araliaceae. Here, we report a chromosome-level genome of Aralia elata with a total length of 1.05 Gb. The loss of 12 exons in the dammarenediol synthase (DDS)-encoding gene in A. elata after divergence from Panax might have caused the lack of dammarane-type saponin production, and a complementation assay shows that overexpression of the PgDDS gene from Panax ginseng in callus of A. elata recovers the accumulation of dammarane-type saponins. Tandem duplication events of triterpene biosynthetic genes are common in the A. elata genome, especially for AeCYP72As, AeCSLMs, and AeUGT73s, which function as tailoring enzymes of oleanane-type saponins and aralosides. More than 13 aralosides are de novo synthesized in Saccharomyces cerevisiae by overexpression of these genes in combination. This study sheds light on the diversity of saponins biosynthetic pathway in Araliaceae and will facilitate heterologous bioproduction of aralosides.

Interplay of distributions of multiple guest molecules in block copolymer micelles: A dissipative particle dynamics study.

HYPOTHESIS: Delivery of multiple payloads using the same micelle is of significance to achieve multifunctional or synergistic effects. The interacting distribution of different payloads in micelles is expected to influence the loading stability and capacity. It is highly desirable to explore how intermolecular interactions affect the joint distribution of multi-payloads. EXPERIMENTS: Dissipative Particle Dynamics simulations were performed to probe the loading of three payloads: decane with a linear carbon chain, butylbenzene with an aromatic ring connected to carbon chain, and naphthalene with double aromatic rings, within poly(ß-amino ester)-b-poly(ethylene glycol) micelles. Properties of core-shell micelles, e.g., morphological evolution, radial density distribution, mean square displacement, and contact statistics, were analyzed to reveal payloads loading stability and capacity. Explorations were extended to vesicular, multi-compartment, double helix, and layer-by-layer micelles with more complex inner structures. FINDINGS: Different payloads have their own preferred locations. Decane locates at the hydrophilic/hydrophobic interface, butylbenzene occupies both the hydrophilic/hydrophobic interface and the hydrophobic core, while naphthalene enters the hydrophobic core. More efficient delivery of multi-payloads is achieved since the competition of payloads occupying preferred locations is minimized. The fusion of micelles encapsulating different payloads suggests that specific payloads will move to their preferred positions without interfering other payloads.

Increased clearance of indoxyl sulphate in renal failure rats with the addition of water-soluble poly-ß-cyclodextrin to the dialysate.

AIM: Indoxyl sulphate (IS), a protein-bound uremic toxin that dramatically increases in the sera of patients with end-stage renal disease (ESRD), is poorly removed by conventional haemodialysis (HD). The purpose of this study was to explore whether the addition of water-soluble sorbent poly-ß-cyclodextrins (PCDs) to dialysate can increase the clearance of IS in uremic rats in vivo. METHODS: Male SD rats (450-550 g, n = 18) with nephrectomy plus IS injection (10-mg/kg) were randomly divided into three groups: 1. The HD group (n = 6): conventional HD for 4 h; 2. the 2% PCD group: 2% PCD added to the dialysate, HD for 4 h; and 3. the 4% PCD group: 4% PCD added to the dialysate, HD for 4 h. The serum IS levels in model rats were similar to those of ESRD patients. A stable and safe rat HD treatment mode was established by adjusting the vascular access, blood flow rate, dialysate flow rate, dialysis pipe, dialysate configuration, temperature, treatment environment, and other aspects. RESULTS: Our study found that adding 2% PCD to dialysate significantly improved the clearance of IS approximately twofold compared with conventional HD. Further increasing the PCD concentration to 4% did not increase IS clearance. CONCLUSION: Therefore, our study showed that adding water-soluble sorbent PCDs to dialysate significantly improved the clearance of IS in uremic rats in vivo.

KDM6 Demethylases and Their Roles in Human Cancers.

Cancer therapy is moving beyond traditional chemotherapy to include epigenetic approaches. KDM6 demethylases are dynamic regulation of gene expression by histone demethylation in response to diverse stimuli, and thus their dysregulation has been observed in various cancers. In this review, we first briefly introduce structural features of KDM6 subfamily, and then discuss the regulation of KDM6, which involves the coordinated control between cellular metabolism (intrinsic regulators) and tumor microenvironment (extrinsic stimuli). We further describe the aberrant functions of KDM6 in human cancers, acting as either a tumor suppressor or an oncoprotein in a context-dependent manner. Finally, we propose potential therapy of KDM6 enzymes based on their structural features, epigenetics, and immunomodulatory mechanisms, providing novel insights for prevention and treatment of cancers.

Promising Roles of Exosomal microRNAs in Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease characterized by the loss of immune tolerance. Lupus nephritis (LN) is still a major cause of the morbidity and mortality of SLE. In clinical practice, diagnosis, and therapy of SLE is complicated and challenging due to lack of ideal biomarkers. Exosomes could be detected from numerous kinds of biological fluids and their specific contents are considered as hallmarks of autoimmune diseases. The exosomal miRNA profiles of SLE/LN patients significantly differ from those of the healthy controls making them as attractive biomarkers for renal injury. Exosomes are considered as optimal delivery vehicles owing to their higher stable, minimal toxicity, lower immunogenicity features and specific target effects. Endogenous miRNAs can be functionally transferred by exosomes from donor cells to recipient cells, displaying their immunomodulatory effects. In addition, it has been confirmed that exosomal miRNAs could directly interact with Toll-like receptors (TLRs) signaling pathways to regulate NF-κB activation and the secretion of inflammatory cytokines. The present Review mainly focuses on the immunomodulatory effects of exosomal-miRNAs, the complex interplay between exosomes, miRNAs and TLR signaling pathways, and how the exosomal-miRNAs can become non-invasive diagnostic molecules and potential therapeutic strategies for the management of SLE.