In this line, Ning J et al. described no expression of α1- antitrypsin (AT) in uEVs of healthy or prediabetic patients, while uEV α1-AT content gradually increased in diabetic patients according to the aggravation of DKD and the decline of renal function, suggesting its possible use as an early diagnosis biomarker for DKD assessment [79]. Here, SERPINA1 is linked to diabetic kidney disease.