Migrasomes in kidney diseases: emerging molecular mechanisms, diagnostic value, and therapeutic prospects

Migrasomes are migration-dependent extracellular organelles that form on retraction fibers of migrating cells. Although they can enter the extracellular space, their biogenesis and membrane organization are distinct from those of conventional extracellular vesicle subtypes. They are involved in intercellular signaling, clearance of cellular material, and maintenance of mitochondrial homeostasis. Emerging evidence suggests their involvement in the development of kidney diseases, such as podocyte injury, membranous nephropathy, diabetic kidney disease (DKD), and renal cell carcinoma (RCC). Podocyte-derived migrasomes in urine have shown potential as non-invasive biomarkers for early detection of kidney injury, with levels correlating with PLA2R antigen expression in membranous nephropathy. In DKD, migrasomes may help mitigate oxidative stress by removing damaged mitochondria. In clear cell renal cell carcinoma, they appear to influence the tumor microenvironment, affecting disease progression and prognosis. However, research on migrasomes in kidney diseases is still in its early stages. Challenges, including an incomplete understanding of their mechanisms and a lack of standardized detection methods, limit clinical application. This review outlines recent advances in understanding migrasomes and explores their potential for early diagnosis, disease monitoring, and prognosis evaluation in kidney diseases, while discussing existing barriers to guide future research efforts.