In another recent paper, the incubation of renal fibroblasts (NRK-49F) with exosomes from HG-treated PTECs induced proliferation and activation of fibroblasts with subsequent production of fibronectin, αSMA and collagen type I. Cell-to-cell communication mediated by PTEC-derived exosomes contributed to the onset of interstitial fibrosis in diabetic kidney disease (DKD) in which exosomal enolase 1 (Eno1) could play a pivotal role [84]. This evidence concerns the gene ACTA1 and diabetic kidney disease.