Proteomics of urinary small extracellular vesicles in early diagnosis of kidney diseases in children‐expectations and limitations

Abstract

The primary function of the kidneys is to maintain systemic homeostasis (disruption of renal structure and function results in multilevel impairment of body function). Kidney diseases are characterized by a chronic, progressive course and may result in the development of chronic kidney disease (CKD). Evaluation of the composition of the proteome of urinary small extracellular vesicles (sEVs) as a so‐called liquid biopsy is a promising new research direction. Knowing the composition of sEV could allow localization of cellular changes in specific sections of the nephron or the interstitial tissue before fixed changes, detectable only at an advanced stage of the disease, occur. Research is currently underway on the role of sEVs in the diagnosis and monitoring of many disease entities. Reports in the literature on the subject include: diabetic nephropathy, focal glomerulosclerosis in the course of glomerulopathies, renal fibrosis of various etiologies. Studies on pediatric patients are still few, involving piloting if small groups of patients without validation studies. Here, we review the literature addressing the use of sEV for diagnosis of the most common urinary disorders in children. We evaluate the clinical utility and define limitations of markers present in sEV as potential liquid biopsy.

Cell Type-Specific Extracellular Vesicles and Their Impact on Health and Disease

“…Chronic kidney disease (CKD) follows a slow, progressive course with biopsy as the gold standard diagnostic tool to determine etiology. The evaluation of urinary small EVs may serve as a “liquid” biopsy [ 226 , 227 ]. As an example, Barutta et al found urinary extracellular vesicles from patients with diabetic nephropathy, showing an enrichment of miR-130a and miR-145 and a reduction in miR-155 and miR-424 [ 228 ].…”