Single urinary extracellular vesicle proteomics identifies complement receptor CD35 as a biomarker for sepsis-associated acute kidney injury

Abstract Sepsis-associated acute kidney injury (SA-AKI) portends severe health burden due to significant morbidity and mortality, while early diagnosis remains challenging. In this study, proximity-dependent barcoding assay (PBA) is established to profile the surface proteome of single urinary extra...

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Main Authors: Ning Li, Tao-Tao Tang, Menglei Gu, Yu-Qi Fu, Wei-Wei Qian, Nan Nan Ma, An-Ran Shen, Tingting Zhu, Run-Bo Huo, Tao Zhang, Jian-Feng Xie, Lu Zhang, Bi-Cheng Liu, Lin-Li Lv
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-62229-4
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author Ning Li
Tao-Tao Tang
Menglei Gu
Yu-Qi Fu
Wei-Wei Qian
Nan Nan Ma
An-Ran Shen
Tingting Zhu
Run-Bo Huo
Tao Zhang
Jian-Feng Xie
Lu Zhang
Bi-Cheng Liu
Lin-Li Lv
author_facet Ning Li
Tao-Tao Tang
Menglei Gu
Yu-Qi Fu
Wei-Wei Qian
Nan Nan Ma
An-Ran Shen
Tingting Zhu
Run-Bo Huo
Tao Zhang
Jian-Feng Xie
Lu Zhang
Bi-Cheng Liu
Lin-Li Lv
author_sort Ning Li
collection DOAJ
description Abstract Sepsis-associated acute kidney injury (SA-AKI) portends severe health burden due to significant morbidity and mortality, while early diagnosis remains challenging. In this study, proximity-dependent barcoding assay (PBA) is established to profile the surface proteome of single urinary extracellular vesicle (uEV). Principle uEV clusters with unique function and origination are profiled in SA-AKI in a screening cohort. Complement receptor CD35 on single uEV (CD35-uEV) displays high diagnostic accuracy for SA-AKI (AUC-ROC 0.89 in validation cohort, n = 134). Besides, CD35-uEV enables identification of subclinical AKI (AUC-ROC 0.84 in prospective cohort, n = 72). Moreover, CD35-uEV correlates closely with AKI severity which also predicts persistent AKI (AUC-ROC 0.77), mortality risks (AUC-ROC 0.70) and progression to AKD (AUC-ROC 0.66). Multi-omics profiling reveals that CD35-uEV are predominantly released from injured podocytes exhibiting diminished CD35 expression. Overall, this study identifies a single uEV biomarker related to injured podocyte for early diagnosis and risk stratification of SA-AKI.
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publishDate 2025-07-01
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series Nature Communications
spelling doaj-art-46da5a2623b645ec9315d29a1a4451da2025-08-20T03:43:22ZengNature PortfolioNature Communications2041-17232025-07-0116111810.1038/s41467-025-62229-4Single urinary extracellular vesicle proteomics identifies complement receptor CD35 as a biomarker for sepsis-associated acute kidney injuryNing Li0Tao-Tao Tang1Menglei Gu2Yu-Qi Fu3Wei-Wei Qian4Nan Nan Ma5An-Ran Shen6Tingting Zhu7Run-Bo Huo8Tao Zhang9Jian-Feng Xie10Lu Zhang11Bi-Cheng Liu12Lin-Li Lv13Institute of Nephrology, Southeast University School of Medicine, Zhong Da HospitalInstitute of Nephrology, Southeast University School of Medicine, Zhong Da HospitalAffiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese MedicineInstitute of Nephrology, Southeast University School of Medicine, Zhong Da HospitalDepartment of Urology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Urology, The Second Affiliated Hospital of Anhui Medical UniversityInstitute of Nephrology, Southeast University School of Medicine, Zhong Da HospitalInstitute of Nephrology, Southeast University School of Medicine, Zhong Da HospitalJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Southeast University School of Medicine, Zhongda HospitalDepartment of Urology, The Second Affiliated Hospital of Anhui Medical UniversityJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Southeast University School of Medicine, Zhongda HospitalAffiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese MedicineInstitute of Nephrology, Southeast University School of Medicine, Zhong Da HospitalInstitute of Nephrology, Southeast University School of Medicine, Zhong Da HospitalAbstract Sepsis-associated acute kidney injury (SA-AKI) portends severe health burden due to significant morbidity and mortality, while early diagnosis remains challenging. In this study, proximity-dependent barcoding assay (PBA) is established to profile the surface proteome of single urinary extracellular vesicle (uEV). Principle uEV clusters with unique function and origination are profiled in SA-AKI in a screening cohort. Complement receptor CD35 on single uEV (CD35-uEV) displays high diagnostic accuracy for SA-AKI (AUC-ROC 0.89 in validation cohort, n = 134). Besides, CD35-uEV enables identification of subclinical AKI (AUC-ROC 0.84 in prospective cohort, n = 72). Moreover, CD35-uEV correlates closely with AKI severity which also predicts persistent AKI (AUC-ROC 0.77), mortality risks (AUC-ROC 0.70) and progression to AKD (AUC-ROC 0.66). Multi-omics profiling reveals that CD35-uEV are predominantly released from injured podocytes exhibiting diminished CD35 expression. Overall, this study identifies a single uEV biomarker related to injured podocyte for early diagnosis and risk stratification of SA-AKI.https://doi.org/10.1038/s41467-025-62229-4
spellingShingle Ning Li
Tao-Tao Tang
Menglei Gu
Yu-Qi Fu
Wei-Wei Qian
Nan Nan Ma
An-Ran Shen
Tingting Zhu
Run-Bo Huo
Tao Zhang
Jian-Feng Xie
Lu Zhang
Bi-Cheng Liu
Lin-Li Lv
Single urinary extracellular vesicle proteomics identifies complement receptor CD35 as a biomarker for sepsis-associated acute kidney injury
Nature Communications
title Single urinary extracellular vesicle proteomics identifies complement receptor CD35 as a biomarker for sepsis-associated acute kidney injury
title_full Single urinary extracellular vesicle proteomics identifies complement receptor CD35 as a biomarker for sepsis-associated acute kidney injury
title_fullStr Single urinary extracellular vesicle proteomics identifies complement receptor CD35 as a biomarker for sepsis-associated acute kidney injury
title_full_unstemmed Single urinary extracellular vesicle proteomics identifies complement receptor CD35 as a biomarker for sepsis-associated acute kidney injury
title_short Single urinary extracellular vesicle proteomics identifies complement receptor CD35 as a biomarker for sepsis-associated acute kidney injury
title_sort single urinary extracellular vesicle proteomics identifies complement receptor cd35 as a biomarker for sepsis associated acute kidney injury
url https://doi.org/10.1038/s41467-025-62229-4
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