Introduction: The kidney transplantation is only treatment regime for end-stage renal disease (ESRD). The study of the immune repertoire in organ transplant is crucial to effectively understand what triggers and sustains the rejection process and how it may eventually accelerate the path toward graft failure. Dendritic cells play major role in maintaining the homeostasis of immune-tolerance that greatly influence the survival of kidney graft in the host. Dendritic cells (DC) excrete small (approximately 30–100 nm in diameter) membrane-enclosed vesicles called exosomes that are derived from multivesicular bodies (MVBs), which have been proposed to play an important role in antigen presentation, immune regulation, and signal transduction. The rationale of this study was to identify immunoregulatory RNA and protein signatures released by donor dendritic cells exosomes.  
Methods: The dendritic cells were isolated from donor blood (N=20) using EasySep™ Human Pan-DC Pre-Enrichment Kit (Stem cell technologies), supplemented with RPMI-10 containing 800 U/ml GM-CSF and 500 U/ml IL-4. The Exosomes were isolated from cell culture supernatant using modified ultracentrifugation protocol, characterized using transmission electron microscopy (size from 65nm-100nm) & CD63 western blot analysis. We measured the exosomal RNA using RNA sequencing and secretome analysis using mass spectrometry.
Results: We showed that 11 % of total PBMCs expressed CD11c+ DCs displaying myeloid lineage DCs. The extracellular RNA sequencing and cluster analysis revealed differentially expressed genes related to immune functions.  Mass spectrometry analysis have identified different proteins and growth factors important for the immunoregulations. The identified RNA and protein profile were again clustered to specific immune tolerance genes & proteins.
Conclusion: This study provide evidence donor dendritic cells derived exosomes have ability to reprogram host immune cells responsible for survival of allograft in kidney transplantation. This could lead to novel intervention strategies to improve graft function and survival.