KIDNEY EXTRACELLULAR VESICLE ATLAS: A SYSTEMATIC REVIEW OF FLOW CYTOMETRY STUDIES MAPPING NEPHRON SEGMENT SOURCE OF URINE EXTRACELLULAR VESICLES

 

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https://storage.unitedwebnetwork.com/files/1099/80f1e5736d45801bd85076292fbd362f.pdf
KIDNEY EXTRACELLULAR VESICLE ATLAS: A SYSTEMATIC REVIEW OF FLOW CYTOMETRY STUDIES MAPPING NEPHRON SEGMENT SOURCE OF URINE EXTRACELLULAR VESICLES

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Chin-Ya Sophie
Chiang
Chin-Ya Sophie Chiang chinya.chiang@health.qld.gov.au Royal Brisbane and Women's Hospital Kidney Health Service Brisbane Australia *
Samantha Upson zez5ud@virginia.edu University of Virginia Health System Department of Medicine, Division of Nephrology Virginia United States -
Fabian Braun fa.braun@uke.de University Medical Center Hamburg-Eppendorf III Department of Medicine and Hamburg Center for Kidney Health Hamburg Germany -
Benedetta Bussolati benedetta.bussolati@unito.it University of Torino Department of Medical Sciences Torino Italy -
Cristina Grange cristina.grange@unito.it University of Torino Department of Medical Sciences Torino Italy -
Uta Erdbruegger ue2u@uvahealth.org University of Virginia Health System Department of Medicine, Division of Nephrology Virginia United States -
Monica Suet Ying Ng Monica.Ng@health.qld.gov.au Royal Brisbane and Women's Hospital Kidney Health Service Brisbane Australia -
 
 
 
 
 
 
 
 

Urine extracellular vesicles (uEVs) are a heterogeneous group of bi-lipid encapsulated vesicles with a majority of them originating from kidney. These kidney-derived uEVs display distinct protein markers reflective of nephron segment-of-origin, along with injury-associated proteins, offering an insight into the pathological state of its source cell. The most common methods of analysing protein expression on uEVs are western blot, mass spectrometry, and flow cytometry. The key strength of flow cytometric analysis of EVs include its capacity for high-throughput single and bulk EV analysis. Various studies have evaluated kidney markers on uEVs using a range of flow cytometers. 

This study systematically analysed single and bead-based flow cytometric approaches to assessing nephron segment markers on uEVs. Articles published between 1 January, 2000 and 31 August, 2025 reporting flow cytometric analysis of human uEVs were searched in PubMed. Studied uEV markers were mapped to nephron segments using single cell RNA sequencing data from the Kidney Precision Medicine Project. Participant characteristics, cohort size, urine collection methods, and uEV isolation techniques for each study were also summarised. 

A total of 48 protein markers were reported from 26 journal articles with 5 podocyte-derived uEV markers (NPHS1, NPHS2, PODXL, PDPN, TIMP2), 11 proximal tubule-derived uEV markers (CD10, URAT, CD13, CD26, LRP2, AQP1, CEACAM, β-1AR, SM22α, SLC9A3, GAPDH), 14 loop of henle-derived uEV markers (CD9, CK8, UMOD, V-ATPase, PROM2, TMEM27, ILGFBP7, CD63, TSG101, CD81, LAMP1, HSP90A, HSP90B, CK18, UC1), 2 distal tubule-derived uEV markers (SLC12A3, claudin-1), 2 collecting duct-derived uEV markers (AQP2, SLC14A2) and 5 injury uEV markers (MCP1, OPN, NGAL, CD133, CD24). Podocalyxin, CD9, and AQP2 have been reported in the most studies (six studies). Furthermore, 7 different flow cytometers were employed across 26 studies, including conventional and imaging flow cytometers. Conventional flow cytometers were the most commonly used. No studies used spectral flow cytometers or nano-flow cytometers. 

A range of nephron segment markers have been identified on uEVs using flow cytometry. Notably, flow cytometry protocols and flow cytometer sensitivity has improved significantly over the study period signalling the need to reassess kidney markers on uEVs with current technologies (e.g. spectral flow cytometry, nano flow cytometry). Identifying nephron segment markers on uEVs is an important step to developing uEVs as biomarkers of kidney disease as it enables the localisation of reno-protective and pathological uEVs.  

Kewords