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The role of immune dysfunction in haemodialysis patients with UCM remains unclear. Peripheral blood mononuclear cells (PBMCs) are major components of the immune system; however, they do not directly contact cardiomyocytes. In general, extracellular vesicles (EVs) function as intercellular communication mediators. Therefore, in this study, we first investigated the role of PBMC\u2010derived EVs (PBMC\u2010EVs) in UCM and identified EV\u2010miR\u2010744\u20105p as a key molecule involved in PBMC\u2013cardiomyocyte communication. Mechanistically, indoxyl sulphate (IS) downregulated miR\u2010744\u20105p expression in PBMC\u2010EVs, leading to IGF2R upregulation in cardiomyocytes, thereby exacerbating myocardial injury via induction of hypertrophy, apoptosis and inflammatory pathway activation in the cardiomyocytes. We also explored the potential of natural products to treat UCM by modifying PBMC\u2010EVs and found that the traditional Chinese medicine monomer salvianolic acid B (Sal B) could bind to YY1, enhancing miR\u2010744\u20105p expression in PBMC\u2010EVs and thus mitigating myocardial injury in UCM. Taken together, these findings indicate the critical role of PBMC\u2010EVs in UCM and suggest the cardioprotective effects of Sal B via PBMC\u2010EV modification. They also provide novel insights into immune mechanisms underlying UCM, particularly indicating that targeting PBMC\u2010EVs may be a promising UCM treatment strategy.<\/jats:p>","DOI":"10.1002\/jev2.70331","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T13:01:28Z","timestamp":1784293288000},"source":"Crossref","is-referenced-by-count":0,"title":["Salvianolic Acid B Upregulates miR\u2010744\u20105p Expression in Peripheral Blood Mononuclear Cell\u2013Derived Extracellular Vesicles to Alleviate Uremic Cardiomyopathy"],"prefix":"10.1002","volume":"15","author":[{"given":"Ziran","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nephrology The First Affiliated Hospital of Dalian Medical University  Dalian Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaojiao","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Nephrology The First Affiliated Hospital of Dalian 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