A noninvasive method of diagnosing membranous nephropathy using exosomes derived from urine.

IF 2.9 3区 医学 Q1 UROLOGY & NEPHROLOGY Kidney Research and Clinical Practice Pub Date : 2024-09-26 DOI:10.23876/j.krcp.23.208
Giae Yun, Taewoon Kim, Kwang Sik Kim, Kyusoon Shin, Jin-Ho Paik, Jee Yoon Park, Luke P Lee, Jong Wook Hong, Sejoong Kim
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Abstract

Background: Membranous nephropathy (MN) is a specific autoimmune disease affecting kidneys. It is characterized by the accumulation of immune complexes in the glomerular basement membrane. Renal biopsy is currently the standard procedure to confirm the diagnosis, although the presence of autoantibodies against the phospholipase A2 receptor (PLA2R) can also help diagnose. In this study, we aimed to investigate the potential of urinary exosomes as noninvasive markers for diagnosing MN.

Methods: Exosomes were extracted from urine samples of five patients with MN and four healthy controls. The concentration of PLA2R was measured in both urine and isolated exosomes using enzyme-linked immunosorbent assay techniques. The measurements were adjusted based on the urine creatinine (UCr) level of each participant.

Results: The levels of PLA2R/UCr were investigated in urine and urine-derived exosomes from patients and controls. Results of the analysis revealed significantly higher expression of PLA2R/UCr in patients compared to the control group (p < 0.05). Furthermore, the expression level of PLA2R/UCr was higher in urine-derived exosomes than in urine samples. Additionally, a positive correlation was observed between the expression levels of PLA2R/UCr and the urine protein-to-creatinine ratio, with urine-derived exosomes exhibiting a stronger correlation than urine samples.

Conclusion: Studies have indicated that measuring exosomal PLA2R/UCr levels in urine could be a noninvasive method for diagnosing MN. Using urine-derived exosomes could also reduce the burden of performing a biopsy on patients and facilitate follow-up treatment, such as monitoring for future recurrence.

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利用从尿液中提取的外泌体诊断膜性肾病的无创方法。
背景:膜性肾病(MN膜性肾病(MN)是一种影响肾脏的特殊自身免疫性疾病。其特点是免疫复合物在肾小球基底膜上堆积。目前,肾活检是确诊的标准程序,但磷脂酶 A2 受体(PLA2R)自身抗体的存在也有助于诊断。本研究旨在探讨尿液外泌体作为诊断 MN 的非侵入性标记物的潜力:方法:从五名 MN 患者和四名健康对照者的尿液样本中提取外泌体。采用酶联免疫吸附测定法测量尿液和分离的外泌体中 PLA2R 的浓度。测量结果根据每位参与者的尿肌酐(UCr)水平进行了调整:结果:研究了患者和对照组尿液和尿液外泌体中 PLA2R/UCr 的水平。分析结果显示,与对照组相比,患者体内的 PLA2R/UCr 表达量明显更高(p < 0.05)。此外,尿液外泌体中 PLA2R/UCr 的表达水平高于尿液样本。此外,还观察到 PLA2R/UCr 的表达水平与尿蛋白-肌酐比值呈正相关,尿液中的外泌体比尿液样本的相关性更强:结论:研究表明,测量尿液中外泌体 PLA2R/UCr 的水平可作为诊断 MN 的一种无创方法。使用尿液中的外泌体还能减轻患者进行活组织检查的负担,并有助于后续治疗,如监测未来的复发情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.60
自引率
10.00%
发文量
77
审稿时长
10 weeks
期刊介绍: Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.
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