EVs/exosomes derived from cystic cells and urinary exosomes derived from ADPKD patients not only affected recipient cell function but also promoted cyst growth in PKD1 mutant mice and 3D cultures by downregulating PKD1 gene expression and upregulating miRNAs, including miR-200s and miR-21, leading to the activation of PKD-associated signaling pathways. The gene discussed is PKD1; the disease is autosomal dominant polycystic kidney disease.