Large-scale proteomics and phosphoproteomics of urinary exosomes.
Journal: 2009/February - Journal of the American Society of Nephrology : JASN
ISSN: 1533-3450
Abstract:
Normal human urine contains large numbers of exosomes, which are 40- to 100-nm vesicles that originate as the internal vesicles in multivesicular bodies from every renal epithelial cell type facing the urinary space. Here, we used LC-MS/MS to profile the proteome of human urinary exosomes. Overall, the analysis identified 1132 proteins unambiguously, including 177 that are represented on the Online Mendelian Inheritance in Man database of disease-related genes, suggesting that exosome analysis is a potential approach to discover urinary biomarkers. We extended the proteomic analysis to phosphoproteomic profiling using neutral loss scanning, and this yielded multiple novel phosphorylation sites, including serine-811 in the thiazide-sensitive Na-Cl co-transporter, NCC. To demonstrate the potential use of exosome analysis to identify a genetic renal disease, we carried out immunoblotting of exosomes from urine samples of patients with a clinical diagnosis of Bartter syndrome type I, showing an absence of the sodium-potassium-chloride co-transporter 2, NKCC2. The proteomic data are publicly accessible at http://dir.nhlbi.nih.gov/papers/lkem/exosome/.
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J Am Soc Nephrol 20(2): 363-379

Large-Scale Proteomics and Phosphoproteomics of Urinary Exosomes

RESULTS

Large-Scale Proteomic Profiling of Human Urinary Exosomes

In this study, we carried out proteomic profiling of a low-density membrane fraction from human urine consisting chiefly of exosomes, using a highly sensitive LC-MS/MS system, based on an ion trap mass spectrometer (LTQ; Thermo-Finnigan; Thermo Electron, San Jose, CA). We unambiguously identified 1132 proteins including 205 proteins seen in our previous study and 927 proteins not seen in our previous study of human urinary exosomes.1 The full list (ambiguous and unambiguous identifications) contains 1412 proteins and can be viewed in Supplemental Table 1, and the list of proteins that were unambiguously identified in both studies can be viewed at http://dir.nhlbi.nih.gov/papers/lkem/exosome/. The expanded list of exosomal proteins includes 177 proteins that are disease related, on the basis of their presence in the OMIM database (Table 1).

Table 1.

Disease-related proteins in human urinary exosomesa

GeneProtein NamePepIDRelated to Disease [OMIM]
ABCB1ATP-binding cassette subfamily B, member 12361Colchicine resistance [MIM: 120080] Crohn disease [MIM: 266600]
ABCC9ATP-binding cassette, subfamily C, member 9 isoform SUR2A-δ-1412Cardiomyopathy [MIM: 608569]
ABCB11ATP-binding cassette, subfamily B (MDR/TAP), member 1113Cholestasis, progressive familial intrahepatic 2 [MIM: 601847]
Cholestasis, benign recurrent intrahepatic 2 [MIM: 605479]
ACAT1Acetyl-CoA acetyltransferase 1 precursor12α-Methylacetoacetic aciduria [MIM: 203750]
ACEAngiotensin I–converting enzyme isoform 1 precursor2396Hypertension [MIM: 106180]
ACEAngiotensin I–converting enzyme isoform 2 precurs1261Renal tubular dysgenesis [267430]
ACE2Angiotensin I–converting enzyme 2 precursor817Hypertension [MIM: 300335]
ACOT7Acyl-CoA thioesterase 7 isoform hBACHd11Mesial temporal lobe epilepsy [MIM: 608096]
ACSL4Acyl-CoA synthetase long-chain family member 4 isoform 212Mental retardation, X-linked 63, MRX 63 [MIM: 300387]
ACY1Aminoacylase 11543Aminoacylase 1 deficiency [MIM: 609924]
AHCYS-adenosylhomocysteine hydrolase1028Hypermethioninemia [MIM: 180960]
AK1Adenylate kinase 144Hemolytic anemia due to AK1 deficiency [MIM: 103000]
ALADδ-Aminolevulinic acid dehydratase isoform a11Acute hepatic porphyria [MIM: 125270]
ALBAlbumin precursor36139Dysalbuminemic hyperthyroxinemia Hyperthyroxinemia, dysalbuminemic analbuminemia bisalbuminemia [MIM: 103600]
ALDOAAldolase A714Aldolase deficiency of red cells Myopathy and hemolytic anemia [MIM: 103850]
ALPLTissue nonspecific alkaline phosphatase precursor34Hypophostasia [MIM: 241500]
AMNAmnionless protein precursor11Megaloblastic anemia 1 [MIM: 261100]
ANPEPMembrane alanine aminopeptidase precursor69412Hypertension [MIM: 151530]
APOA1Apolipoprotein A-I preproprotein617Primary hypoalphalipoproteinemia [MIM: 604091]
APOA2Apolipoprotein A-II preproprotein11Apolipoprotein A-II deficiency, familial
Hypercholesterolemia, familial [MIM: 143890]
APRTAdenine phosphoribosyltransferase isoform a222,8-Dihydroxyadenine urolithiasis [MIM: 102600]
APRTAdenine phosphoribosyltransferase isoform b3102,8-Dihydroxyadenine urolithiasis [MIM: 102600]
AQP1Aquaporin 1335Aquaporin 1 deficiency, Colton-Null [MIM: 110450]
AQP2Aquaporin 2736Autosomal recessive nephrogenic diabetes insipidus, type 1 [MIM: 222000]Autosomal dominant nephrogenic diabetes insipidus, type 1 [MIM: 125800]
ARL6ADP-ribosylation factor–like 647Bardet-Biedl syndrome 3 [MIM: 209900]
ARSEArylsulfatase E precursor12Chondrodysplasia punctata 1, X-linked recessive [MIM: 302950]
ASAH1N-acylsphingosine amidohydrolase (acid ceramidase) 1 preproprotein isoform a716Farber disease [MIM: 228000]
ASAH1N-acylsphingosine amidohydrolase (acid ceramidase) 1 isoform b934Farber disease [MIM: 228000]
ASLArgininosuccinate lyase isoform 311Argoninosuccinic aciduria [MIM: 207900]
ASS1Argininosuccinate synthetase 12059Citrullinemia [MIM: 215700]
ATIC5-Aminoimidazole-4-carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase11Aica-ribosiduria due to ATIC deficiency [MIM: 608688]
ATP6V0A4ATPase, H transporting, lysosomal V0 subunit a412Renal tubular acidosis, distal, autosomal recessive [MIM: 602722]
ATP6V1B1ATPase, H transporting, lysosomal 56/58-kD, V1 subunit B1817Renal tubular acidosis, distal, with progressive deafness [MIM: 267300]
B2Mβ2-Microglobulin precursor11Hypercatabolic hypoproteinemia [MIM: 241600]
B4GALT1UDP-Gal:βGlcNAc β 1,4- galactosyltransferase 1, membrane-bound form11Congenital disorder of glycosylation type IId [MIM: 607091]
CA2Carbonic anhydrase II925Autosomal recessive syndrome of osteopetrosis with renal tubular acidosis [MIM: 259730]
CA4Carbonic anhydrase IV precursor22Proximal renal tubular acidosis [MIM: 114760]
CC2D1ACoiled-coil and C2 domain containing 1A66Mental retardation autosomal recessive 3 [MIM: 608443]
CD2APCD2-associated protein1421Focal segmental glomerulosclerosis FSGS3 [MIM: 607832]
CETPCholesteryl ester transfer protein, plasma precursor714Cholesterol ester transfer protein deficiency [MIM: 607322]
CFHComplement factor H isoform b precursor11Hemolytic uremic syndrome, atypical [MIM: 235400]
CFIComplement factor I11Complement factor I deficiency [MIM: 610984]
CHMP2BChromatin modifying protein 2B415Frontotemporal dementia, chromosome 3-linked [MIM: 6000795]
CLTCClathrin heavy chain 11224Renal cell carcinoma [MIM: 118955]
COL18A1α 1 type XVIII collagen isoform 1 precursor11Knobloch syndrome [MIM: 267750]
COL6A1Collagen, type VI, α 1 precursor621Bethlem myopathy [MIM: 158810] Ullrich congenital muscular dystrophy, autosomal dominant [MIM: 254090]
COL6A3α 3 type VI collagen isoform 5 precursor12Ullrich congenital muscular dystrophy [MIM: 254090]
CPCeruloplasmin precursor615Aceruloplasminemia [MIM: 604290]
CRYABCrystallin, α B712α-B crystallinopathy [MIM: 608810]
CRYMCrystallin, μ isoform 113Autosomal dominant nonsyndromic deafness [MIM: 123740]
CST3Cystatin C precursor13Icelandic-type cerebroarterial amyloidosis [MIM: 105150]
CSTBCystatin B210Myoclonic epilepsy of Unverricht and Lundborg [MIM: 254800]
CTSCCathepsin C isoform b precursor11Papillo-LeFevre syndrome [MIM: 245000]
CTHCystathionase isoform 211Cystathioninuria [MIM: 219500]
CTSACathepsin A precursor315Galactosialidosis [MIM: 256540]
CTSCCathepsin C isoform a preproprotein12Papillon-Lefevre syndrome [MIM: 245000]
CTSDCathepsin D preproprotein12Neuronal ceroid lipofuscinosis [MIM: 610127]
CTNSCystinosis, nephropathic isoform 113Nephropathic cystinosis [MIM: 219800]
CUBNCubilin104672Megaloblastic anemia 1, Finnish type [MIM: 261100]
CUL4BCullin 4B11Cabezas syndrome [MIM: 300354]
Mental retardation-hypotonic facies syndrome [MIM: 300639]
DDAH1Dimethylarginine dimethylaminohydrolase 115Hypertension [MIM: 604743]
DDCDopa decarboxylase (aromatic l-amino acid decarboxylase)1131Aromatic L-amino acid decarboxylase deficiency [MIM: 608643]
DNM2Dynamin 2 isoform 311Charcot-Marie-Tooth disease,
Dominant intermediate B [MIM: 606482]
DNM2Dynamin 2 isoform 411Charcot-Marie-Tooth neuropathy,
Dominant intermediate B [MIM: 606482]
DYSFDysferlin11Miyoshi myopathy [MIM: 254130]
DPYSDihydropyrimidinase56Dihydropyrimidinuria [MIM: 222748]
DSC2Desmocollin 2 isoform Dsc2b preproprotein13Arrhythmogenic right ventricular dysplasia-11 [MIM: 610476]
DSPDesmoplakin isoform II1016Keratosis palmoplantaris striata II dilated cardiomyopathy with woolly hair and keratoderma [MIM: 605676]
ECE1Endothelin-converting enzyme 111Hirschsprung disease [MIM: 142623]
EFEMP1EGF-containing fibulin–like extracellular matrix protein 1 precursor13Doyne Honeycomb retinal dystrophy [MIM: 126600]
ELA2Elastase 2, neutrophil preproprotein11Cyclic hematopoiesis [MIM: 162800]
ENPEPGlutamyl aminopeptidase (aminopeptidase A)25100Hypertension [MIM: 138297]
FAHFumarylacetoacetate hydrolase (fumarylacetoacetase)22Tyrosinemia type I [MIM: 276700]
FLNBFilamin B, β (actin-binding protein 278)11Spondylocarpotarsal synostosis syndrome [MIM: 272460]
FBP1Fructose-1,6-bisphosphatase 1716Fructose-1,6-bisphosphatase deficiency [MIM: 229700]
FGAFibrinogen, α polypeptide isoform α-E preproprotein517Renal amyloidosis [MIM: 105200] Dysfibrinogenemia [MIM: 134820]
FGGFibrinogen, γ chain isoform γ-A precursor11Dysfibrinogenemia[MIM: 134850]
FTCDFormiminotransferase cyclodeaminase47Glutamate formiminotransferase deficiency [MIM: 229100]
FTH1Ferritin, heavy polypeptide 117Iron overload, autosomal dominant [MIM: 134770]
FTLFerritin, light polypeptide514Hyperferritinemia-cataract syndrome [MIM: 600886]
FUCA1Fucosidase, α-L-1, tissue11Fucosidosis [MIM: 230000]
FXYD2FXYD domain–containing ion transport regulator 2 isoform 117Hypomagnesemia 2, renal [MIM: 154020]
G6PDGlucose-6-phosphate dehydrogenase isoform a11Nonspherocytic hemolytic anemia due to G6PD deficiency [MIM: 305900]
GAAAcid α-glucosidase preproprotein48Infantile-onset glycogen storage disease Type II [MIM: 232300]
GALK1Galactokinase 111Galactokinase deficiency [MIM: 230200]
GBE1Glucan (1,4-α-), branching enzyme 112Type IV glycogen storage disease [MIM: 232500]
GCS1Mannosyl-oligosaccharide glucosidase11Congenital disorder of glycosylation [MIM: 606056]
GKGlycerol kinase isoform a11Glycerol kinase deficiency [MIM: 307030]
GLB1Galactosidase, β 1 isoform a1670Gangliosidosis GM1 [MIM: 230500]
GLULGlutamine synthetase22Congenital glutamine deficiency [MIM: 610015]
GM2AGM2 ganglioside activator precursor23Gangliosidosis GM2 AB variant Tay-Sachs disease [MIM: 272750]
GPIGlucose phosphate isomerase919Chronic hemolytic anemia duet to GPI deficiency [MIM: 172400]
GPR98G protein–coupled receptor 98 precursor11Familial febrile seizures [MIM: 604352] Usher syndrome type IIC [MIM: 605472]
GSNGelsolin isoform b1021Finnish type familial amyloidosis [MIM: 105120]
GSSGlutathione synthetase13Glutathione synthetase deficiency [MIM: 266130]
HNMTHistamine N-methyltransferase isoform 111Susceptibility to asthma [MIM: 600807]
HPD4-Hydroxyphenylpyruvate dioxygenase11Tyrosinemia type III [MIM: 276710]
HPGDHydroxyprostaglandin dehydrogenase 15-(NAD)621Hypertension [MIM: 601688]
HSPG2Heparan sulfate proteoglycan 21841Schwartz-Jampel syndrome type 1 [MIM: 255800]
HSPB1Heat-shock 27-kD protein 1830Charcot-Marie-Tooth disease, type 2F [MIM: 606595] Distal hereditary motor neuropathy IIB [MIM: 608634]
ICAM1Intercellular adhesion molecule 1 precursor11Graves disease [MIM: 275000]
IL1RNInterleukin 1 receptor antagonist isoform 1 precursor22Gastric cancer risk [MIM: 137215]
IRF6Interferon regulatory factor 611Van der Woude syndrome [MIM: 119300] Popliteal pterygium syndrome [MIM: 119500]
ITM2BIntegral membrane protein 2B521Familial dementia [MIM: 176500]
JUPJunction plakoglobin915Naxos disease [MIM: 601214]
KALRNKalirin, RhoGEF kinase isoform 311Coronary heart disease [MIM: 608901]
KHKKetohexokinase isoform a24Essential fructosuria [MIM: 229800]
KLKlotho11Hyperphosphatemic tumoral calcinosis [MIM: 211900]
KLK1Kallikrein 1 preproprotein11Decreased urinary activity of kallikrein [MIM: 147910]
LGALS3Galectin 311Lymphocyte function–associated antigen 1 [MIM: 116920]
LAMP2Lysosomal-associated membrane protein 2 precursor426Danon disease [MIM: 300257]
LRRK2Leucine-rich repeat kinase 245Parkinson disease [MIM: 607060]
LYZLysozyme precursor13Familial visceral amyloidosis [MIM: 105200]
MIFMacrophage migration inhibitory factor (glycosylation-inhibiting factor)16Rheumatoid arthritis [MIM: 604302]
MMEMembrane metallo-endopeptidase neprilysin48311HypertensionImportant cell surface marker in the diagnostic of human acute lymphocytic leukemia [MIM: 120520]
MPOMyeloperoxidase732Myeloperoxidase deficiency [MIM: 254600]
MTHFD1Methylenetetrahydrofolate dehydrogenase 145Spina bifida [MIM: 601634]
MYH14Myosin, heavy chain 14 isoform 111Autosomal dominant nonsyndromic sensorineural deafness [MIM: 600652]
MYH3Myosin, heavy chain 3, skeletal muscle, embryonic11Freeman-Sheldon syndrome [MIM: 193700]
MYH9Myosin, heavy polypeptide 9, nonmuscle1951Fechtner syndrome [MIM: 153640]Epstein syndrome [MIM: 153650]
MYO15AMyosin XV13Recessive congenital deafness [MIM: 600316]
MYO6Myosin VI721Autosomal recessive congenital sensorineural deafness [MIM: 607821] Autosomal dominant nonsyndromic sensorineural deafness [MIM: 606346]
NAGLUα-N-acetylglucosaminidase precursor2163Mucopolysaccharidosis type IIIB [MIM: 252920]
NDRG1N-myc downstream regulated gene 125Charcot-Marie-Tooth disease type 4D [MIM: 601455]
NEBNebulin24Nemaline myopathy [MIM: 256030]
NPHS2Podocin69Autosomal recessive steroid-resistant nephrotic syndrome [MIM: 600995]
PAFAH1B1Platelet-activating factor acetylhydrolase, isoform Ib, α subunit (45 kD)11Miller-Dieker lissencephaly syndrome [MIM: 607432]
PARK7DJ-1 protein11Parkinson disease 7, autosomal recessive [MIM: 606324]
PCBD1Pterin-4 α-carbinolamine dehydratase precursor11Hyperphenylalaninemia [MIM: 264070]
PDCD10Programmed cell death 1023Cerebral cavernous malformations [MIM: 603285]
PHGDHPhosphoglycerate dehydrogenase22Phosphoglycerate dehydrogenase deficiency [MIM: 601815]
PKD1Polycystin 111Polycystic kidney disease, adult, type I [MIM: 601313]
PKD2Polycystin 212Polycystic kidney disease, adult, type II [MIM: 173910]
PKHD1Polyductin isoform 269Autosomal recessive polycystic kidney disease [MIM: 263200]
PKLRPyruvate kinase, liver, and RBC isoform 111Pyruvate kinase deficiency [MIM: 266200]
PLOD1Lysyl hydroxylase precursor11Ehlers-Danlos syndrome, type VIA [MIM: 225400]
PRKCHProtein kinase C, η12Cerebral infarction [MIM: 601367]
PROM1Prominin 123174Autosomal recessive retinal degeneration [MIM: 604365]
PRNPPrion protein preproprotein11Creutzfeldt-Jakob disease [MIM: 123400]
PSAPProsaposin isoform a preproprotein36Metachromatic leukodystrophy due to SAP1 deficiency [MIM: 249900]
Gaucher disease, atypical due to SAP2 deficiency [MIM: 610539]
PSAPProsaposin isoform c preproprotein14Metachromatic leukodystrophy [MIM: 249900]
PSAT1Phosphoserine aminotransferase isoform 124Phosphoserine aminotransferase deficiency [MIM: 610992]
PTPRJProtein tyrosine phosphatase, receptor type, J precursor11Somatic colon cancer [MIM: 114500]
RAB3GAP1RAB3 GTPase-activating protein11Warburg micro syndrome [MIM: 600118]
RBP4Retinol-binding protein 4, plasma precursor23Retinol-binding protein deficiency [MIM: 180250]
RDXRadixin1623Autosomal recessive deafness 24 [MIM: 611022]
ROBO2Roundabout, axon guidance receptor, homolog 211Vesicoureteral reflux 2 [MIM: 610878]
RP2XRP2 protein35X-linked retinitis pigmentosa 2 [MIM: 312600]
RYR1Skeletal muscle ryanodine receptor isoform 111Malignant hyperthermia [MIM: 145600] Central core disease [MIM: 117000] Minicore myopathy with external ophthalmoplegia [MIM: 255320]
SERPING1Complement component 1 inhibitor precursor714Hereditary angioedema type I [MIM: 106100]
SLC3A1Solute carrier family 3, member 11425Cystinuria [MIM: 220100]
SLC4A1Solute carrier family 4, anion exchanger, member 1 [kAE1]22Defective kidney acid secretion leading to distal renal tubular acidosis [MIM: 179800]
SLC4A4Solute carrier family 4, sodium bicarbonate co-transporter, member 4 [NBC1]23Renal tubular acidosis, proximal, with ocular abnormalities [MIM: 604278]
SLC5A1Solute carrier family 5 (sodium/glucose co-transporter), member 1 [SGLT1]23Glucose/galactose malabsorption [MIM: 606824]
SLC5A2Solute carrier family 5 (sodium/glucose co-transporter), member 2 [SGLT2]49Renal glucosuria [MIM: 233100]
SLC6A19Solute carrier family 6, member 1948Hartnup disorder [MIM: 234500]
SLC12A1Sodium potassium chloride co-transporter 2 [NKCC2]2594Bartter syndrome, antenatal, type 1 [MIM: 601678]
SLC12A3Solute carrier family 12 (sodium/chloride transporters), member 3 [NCC]28102Gitelman syndrome [MIM: 263800]
SLC22A12Urate anion exchanger 1 isoform a [URAT1]12Renal hypouricemia [MIM: 220150]
SLC25A3Solute carrier family 25 member 3 isoform b precursor15Mitochondrial phosphate carrier deficiency [MIM: 610773]
SLC26A4Pendrin24Pendred syndrome [MIM: 274600]Deafness, autosomal recessive 4 [MIM: 600791]
SLC44A4NG22 protein isoform 1659Sialidosis 1 [MIM: 606107]
SPRSepiapterin reductase (7,8-dihydrobiopterin:NADP + oxidoreductase)12Dystonia, dopa-responsive, due to sepiapterin reductase deficiency [MIM: 251120]
SQSTM1Sequestosome 112Paget disease of bone [MIM: 602080]
SUCLA2Succinate-CoA ligase, ADP-forming, β subunit11Mitochondrial DNA depletion syndrome [MIM: 609560]
TECTATectorin α precursor11Autosomal dominant nonsyndromic sensorineural hearing loss [MIM: 601842]
TFTransferrin1220Alzheimer disease [MIM: 104300]
TPP1Tripeptidyl-peptidase I preproprotein842Ceroid lipofuscinosis neuronal 2 [MIM: 204500]
TSG101Tumor susceptibility gene 1011766Breast cancer [MIM: 176960]
TTNTitin isoform novex 145Cardiomyopathy [MIM: 188840]
UMODUromodulin precursor351278Medullary cystic kidney disease-2 (MCKD2) [MIM: 603860]Familial juvenile hyperuricemic nephropathy (FJHN) [MIM: 16200]
VCPValosin-containing protein22Inclusion body myopathy with early-onset Paget disease and frontotemporal dementia [MIM: 167320]
VAMP7Vesicle-associated membrane protein 711β-Ureidopropionase deficiency [MIM: 606673]
VCLVinculin isoform meta-VCL35Cardiomyopathy, dilated [MIM: 611407]
VWFVon Willebrand factor preproprotein14Von Willebrand disease [MIM: 193400]
ZMPSTE24Zinc metalloproteinase STE2411Mandibuloacral dysplasia [MIM: 608612]
Information for each protein include “Gene” name, “Protein Name”, “Pep” refers to the number of unique peptides identified in LC-MS/MS, “ID” refers to the number of spectra and “Related to Disease [OMIM]” refers to the disease with which the protein is related according to OMIM. The 34 proteins associated with kidney diseases are presented in italics.

Predictably, a large number of proteins that were identified were integral membrane proteins involved in solute and water transport (Table 2). As seen in our previous study,1 these proteins predominantly represent apical transporters present in every renal tubule segment, including the proximal tubule (sodium-hydrogen exchanger 3, sodium-glucose co-transporter 1 and 2, and aquaporin-1 [AQP1]), the thick ascending limb (sodium-potassium-chloride co-transporter 2 [NKCC2]), the distal convoluted tubule (thiazide-sensitive Na-Cl co-transporter [NCC]), and connecting tubule/collecting duct (AQP2, rhesus blood group C glycoprotein [RhCG, an ammonia channel], B1 subunit of vacuolar H-ATPase, and pendrin). Note that both polycystin-1 and polycystin-2 were detected in human urinary exosomes.

Table 2.

Solute and water transportersa

Ref SeqGeneProtein NamePepID
NP_000918ABCB1ATP-binding cassette, subfamily B, member 12361
NP_003733ABCB11ATP-binding cassette, subfamily B (MDR/TAP), member 1113
NP_005680ABCB6ATP-binding cassette, subfamily B, member 611
NP_064694ABCC9ATP-binding cassette, subfamily C, member 9 isoform SUR2A-δ-1412
NP_149163ABCC11ATP-binding cassette, subfamily C, member 11 isoform a11
NP_932766AQP1Aquaporin 1335
NP_000477AQP2Aquaporin 2736
NP_000692ATP1A1Na/K-ATPase α 1 subunit isoform a proprotein1957
NP_001001787ATP1B1Na/K-ATPase β 1 subunit isoform b11
NP_001001937ATP5A1ATP synthase, H transporting, mitochondrial F1 complex, α subunit precursor35
NP_001677ATP5BATP synthase, H transporting, mitochondrial F1 complex, β subunit precursor45
NP_001174ATP6AP1ATPase, H transporting, lysosomal accessory protein 1 precursor11
NP_001685ATP6V0CATPase, H transporting, lysosomal, V0 subunit c19
NP_005168ATP6V0A1ATPase, H transporting, lysosomal V0 subunit a isoform 111
NP_065683ATP6V0A4ATPase, H transporting, lysosomal V0 subunit a412
NP_004682ATP6V0D1ATPase, H transporting, lysosomal, V0 subunit d111
NP_689778ATP6V0D2ATPase, H transporting, lysosomal 38 kD, V0 subunit D224
NP_001681ATP6V1AATPase, H transporting, lysosomal 70 kD, V1 subunit A, isoform 12249
NP_001683ATP6V1B1ATPase, H transporting, lysosomal 56/58 kD, V1 subunit B1817
NP_001684ATP6V1B2Vacuolar H-ATPase B21227
NP_001686ATP6V1C1ATPase, H transporting, lysosomal 42 kD, V1 subunit C1 isoform A11
NP_001034451ATP6V1C2Vacuolar H-ATPase C2 isoform a11
NP_057078ATP6V1DH-transporting two-sector ATPase23
NP_001687ATP6V1E1Vacuolar H-ATPase E1 isoform a22
NP_001034456ATP6V1E1Vacuolar H-ATPase E1 isoform c11
NP_001034455ATP6V1E1Vacuolar H-ATPase E1 isoform b11
NP_004222ATP6V1FATPase, H transporting, lysosomal 14 kD, V1 subunit F11
NP_004879ATP6V1G1Vacuolar H-ATPase G112
NP_998784ATP6V1HATPase, H transporting, lysosomal 50/57 kD, V1 subunit H isoform 1834
NP_036415KCNG2Potassium voltage-gated channel, subfamily G, member 212
NP_853514PKD1L3Polycystin 1–like 311
NP_001009944PKD1Polycystin 1 isoform 1 precursor11
NP_000288PKD2Polycystin 212
NP_057405RHCGRhesus blood group, C glycoprotein58
NP_000531RYR1Skeletal muscle ryanodine receptor isoform 111
NP_006505SCN10ASodium channel, voltage-gated, type X, α111
NP_054858SCN11ASodium channel, voltage-gated, type XI, α11
NP_000329SLC12A1Sodium potassium chloride co-transporter 22594
NP_000330SLC12A3Solute carrier family 12 (sodium/chloride transporters), member 328102
NP_064631SLC12A9Solute carrier family 12 (potassium/chloride transporters), member 911
NP_003975SLC13A2Solute carrier family 13 (sodium-dependent dicarboxylate transporter), member 2510
NP_073740SLC13A3Solute carrier family 13 member 3 isoform a22
NP_001011554SLC13A3Solute carrier family 13 member 3 isoform b13
NP_004161SLC1A1Solute carrier family 1, member 136
NP_066568SLC15A2Solute carrier family 15 (H/peptide transporter), member 211
NP_060954SLC22A11Solute carrier family 22 member 1129
NP_653186SLC22A12Urate anion exchanger 1 isoform a12
NP_003049SLC22A2Solute carrier family 22 member 2 isoform a23
NP_003051SLC22A5Solute carrier family 22 member 511
NP_004781SLC22A6Solute carrier family 22 member 6 isoform a13
NP_695010SLC22A6Solute carrier family 22 member 6 isoform d11
NP_004245SLC22A8Solute carrier family 22 member 812
NP_005838SLC23A1Solute carrier family 23 (nucleobase transporters), member 1 isoform a46
NP_689898SLC23A1Solute carrier family 23 (nucleobase transporters), member 1 isoform b610
NP_005975SLC25A1Solute carrier family 25 (mitochondrial carrier; citrate transporter), member 111
NP_998776SLC25A3Solute carrier family 25 member 3 isoform b precursor15
NP_775897SLC26A11Solute carrier family 26, member 1111
NP_000432SLC26A4Pendrin24
NP_003030SLC2A5Solute carrier family 2 (facilitated glucose/fructose transporter), member 51222
NP_775867SLC39A5Solute carrier family 39 (metal ion transporter), member 511
NP_000332SLC3A1Solute carrier family 3, member 11425
NP_001012679SLC3A2Solute carrier family 3 (activators of dibasic and neutral amino acid transport), member 2 isoform a1018
NP_002385SLC3A2Solute carrier family 3 (activators of dibasic and neutral amino acid transport), member 2 isoform c35
NP_536856SLC44A1CDW92 antigen11
NP_065161SLC44A2CTL2 protein1870
NP_000333SLC4A1Solute carrier family 4, anion exchanger, member 122
NP_003750SLC4A4Solute carrier family 4, sodium bicarbonate co-transporter, member 423
NP_000334SLC5A1Solute carrier family 5 (sodium/glucose co-transporter), member 123
NP_689564SLC5A10Solute carrier family 5 (sodium/glucose co-transporter), member 10 isoform 122
NP_001035915SLC5A10Solute carrier family 5 (sodium/glucose co-transporter), member 10 isoform 213
NP_848593SLC5A12Solute carrier family 5 (sodium/glucose co-transporter), member 12 isoform 224
NP_003032SLC5A2Solute carrier family 5 (sodium/glucose co-transporter), member 249
NP_666018SLC5A8Solute carrier family 5 (iodide transporter), member 811
NP_001011547SLC5A9Solute carrier family 5 (sodium/glucose co-transporter), member 913
NP_057699SLC6A13Solute carrier family 6 (neurotransmitter transporter, GABA), member 1311
NP_001003841SLC6A19Solute carrier family 6, member 1948
NP_004165SLC9A3Solute carrier family 9 (sodium/hydrogen exchanger), isoform 323
NP_004776SLC9A3R2Solute carrier family 9 isoform 3 regulator 211
NP_851322SLCO4C1Solute carrier organic anion transporter family, member 4C122
NP_003365VDAC1Voltage-dependent anion channel 1643
NP_005653VDAC3Voltage-dependent anion channel 311
Table contains all of the proteins that are solute and water transporters.

Exosomes derive from MVB and are delivered to the urine when the outer membranes of MVB fuse with the apical plasma membrane. Interestingly, 22 of the proteins identified in this study are recognized as components of the apparatus responsible for the formation of MVB (Table 3). These 22 proteins account for approximately 75% of the proteins that constitute the ESCRT-0, ESCRT-I, ESCRT-II, and ESCRT-III complexes involved in multivesicular body formation.5

Table 3.

Proteins of the ESCRT complex found in human urinary exosomesa

GeneProtein NamePepIDRef SeqESCRT Complex
HGSHepatocyte growth factor–regulated tyrosine kinase substrate11NP_004703ESCRT-0
TSG101Tumor susceptibility gene 1011547NP_006283ESCRT-I
VPS28Vacuolar protein sorting 28 isoform 158NP_057292ESCRT-I
VPS28Vacuolar protein sorting 28 isoform 228NP_898880ESCRT-I
VPS37BVacuolar protein sorting 37B410NP_078943ESCRT-I
VPS37CVacuolar protein sorting 37C11NP_060436ESCRT-I
VPS25EAP25415NP_115729ESCRT-II
VPS36EAP4523NP_057159ESCRT-II
SNF8EAP3011NP_009172ESCRT-II
CHMP2ACHMP2A640NP_055268ESCRT-III
CHMP2BCHMP2B311NP_054762ESCRT-III
VPS24CHMP313NP_057163ESCRT-III
VPS24CHMP314NP_001005753ESCRT-III
CHMP4BCHMP4B26NP_789782ESCRT-III
CHMP5CHMP527NP_057494ESCRT-III
CHMP1ACHMP1A13NP_002759ESCRT-III
CHMP1BCHMP1B12NP_065145ESCRT-III
CHMP6CHMP623NP_078867ESCRT-III
VPS4AVacuolar protein sorting factor 4A1125NP_037377ATPase complex
VPS4BVacuolar protein sorting factor 4B1132NP_004860ATPase complex
PDCD6IPALIX27104NP_037506Accessory
C1orf58Hypothetical protein LOC1483621134NP_653296Accessory
Table contains all of the proteins that are members of the ESCRT Complex (ESCRT-0, ESCRT-I, ESCRT-II, ESCRT-III, ATPase complex and accessory).

In addition, 17 proteins identified in this study are subunits of the human vacuolar H-ATPase (Table 4). Vacuolar H-ATPases are ATP-dependent proton pumps for proton transport into intracellular organelles.6 These proteins also mediate proton transport across the apical plasma membrane of type A intercalated cells and across the basolateral plasma membrane of type B intercalated cells.7 The B1 subunit is selectively expressed in intercalated cells, and its detection in urinary exosomes establish that intercalated cells secrete exosomes as do other types of epithelial cells lining the renal tubule. These proteins constitute 78% of the subunits of the V0 and V1 domains of the vacuolar H-ATPase.8

Table 4.

Vacuolar H-ATPase subunits in human urinary exosomesa

Ref SeqGeneProtein NamePepID
NP_005168ATP6V0A1ATPase, H transporting, lysosomal V0 subunit a isoform 111
NP_065683ATP6V0A4ATPase, H transporting, lysosomal V0 subunit a412
NP_001685ATP6V0CATPase, H transporting, lysosomal, V0 subunit c11
NP_004682ATP6V0D1ATPase, H transporting, lysosomal, V0 subunit d111
NP_689778ATP6V0D2ATPase, H transporting, lysosomal 38 kD, V0 subunit D224
NP_001681ATP6V1AATPase, H transporting, lysosomal 70 kD, V1 subunit A, isoform 12249
NP_001683ATP6V1B1ATPase, H transporting, lysosomal 56/58 kD, V1 subunit B1817
NP_001684ATP6V1B2vacuolar H-ATPase B21227
NP_001686ATP6V1C1ATPase, H transporting, lysosomal 42 kD, V1 subunit C1 isoform A11
NP_001034451ATP6V1C2vacuolar H-ATPase C2 isoform a11
NP_057078ATP6V1DH(+)-transporting two-sector ATPase23
NP_001687ATP6V1E1vacuolar H-ATPase E1 isoform a22
NP_001034455ATP6V1E1vacuolar H-ATPase E1 isoform b11
NP_001034456ATP6V1E1vacuolar H-ATPase E1 isoform c11
NP_004222ATP6V1FATPase, H transporting, lysosomal 14 kD, V1 subunit F11
NP_004879ATP6V1G1vacuolar H-ATPase G112
NP_998784ATP6V1HATPase, H transporting, lysosomal 50/57 kD, V1 subunit H isoform 1834
Table contains proteins that are found in human urinary exosomes and are subunits of the human vacuolar H-ATPase.

An example of the utility of exosome analysis is shown in Figure 1, describing immunoblotting in patients with Bartter syndrome type I, associated with mutations in the SLC12A1 gene, which encodes for the NKCC2 sodium-potassium-chloride co-transporter protein.9 The NKCC2 protein was found in the proteome of the human urinary exosomes as shown in Table 1. Urine samples were obtained from two patients (patients 1 and 2) with clinical phenotypes consistent with Bartter syndrome type I (Figure 1A).10 The clinical diagnosis for the patients with Bartter syndrome type I was confirmed by the ultrasound images showing deposits of calcium in the kidney also known as nephrocalcinosis910 (Figure 1B) and other typical laboratory findings. The two urinary exosome samples obtained from the patients with Bartter syndrome type I were analyzed by immunoblotting for the presence of the NKCC2 protein (Figure 1C). Compared with the respective control samples, patients 1 and 2 showed an absence of the NKCC2 protein bands, expected at 160 kD for monomeric NKCC2 and 320 kD for dimeric NKCC2. In addition, the samples (patients 1 and 2) were probed for the thiazide-sensitive co-transporter (NCC) protein to ensure that urinary exosomes were successfully isolated and loaded properly. Strong NCC bands were obtained in samples from both patients with Bartter syndrome type I and control samples.

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Disease-related protein: NKCC2 and Bartter syndrome type I. (A) Details of clinical phenotype for patients with Bartter syndrome type I, patient 1 and patient 2. (B) Ultrasound images showing calcium deposits (white arrowheads) in the kidneys of patients 1 and 2. (C) Immunoblot of urinary exosomes samples from patient 1, patient 2, control 1, and control 2 using polyclonal rabbit anti-NKCC2 and NCC antibodies.

Phosphoproteomic Analysis of Human Urinary Exosomes

Protein phosphorylation is a key element of most cell regulatory processes. Recently, technical approaches that allow phosphoproteomic profiling on a large scale have been introduced.41113 We used neutral loss scanning with high-stringency target-decoy analysis to identify phosphorylation sites present in exosomal proteins from human urine samples.

Nineteen phosphorylation sites corresponding to 14 phosphoproteins were identified (Table 5). These included both newly identified phosphorylation sites and sites that had been previously identified. Two orphan G-protein–coupled receptors are included in the former group, viz. GPRC5B and GPRC5C. In GPRC5B, we identified one new phosphorylation site, T389, and, in GPRC5C, we identified three new phosphorylation sites, T435, S395, and Y426. These proteins are also known as retinoic acid–induced gene 2 (GPRC5B) and retinoic acid–induced gene 3 (GPRC5C).

Table 5.

Human urinary exosome phosphopeptidesa

Ref SeqProtein Name, SequenceSiteGeneNovel SiteMSnMotifGO Function
NP_061123G protein–coupled receptor family C, group 5, member C isoform bGPRC5CMetabotropic glutamate, GABA-B–like receptor activity Protein binding Receptor activity
R.AEDMYSAQSHQAA(T*)PPKDGK.NT435YesMS2, MS3Proline-directed
K.VP(S*)EGAYDIILPR.AS395YesMS2, MS3Phosphoserine/threonine binding group
R.AEDM(Y*)SAQSHQAATPPKDGK.NY426YesMS2Tyrosine kinase
NP_001035149Secreted phosphoprotein 1 isoform cSPP1Cytokine activity Growth factor activity Integrin binding Protein binding
K.AIPVAQDLNAPSDWD(S*)R.GS192NoMS2Miscellaneous
R.GKD(S*)YETSQLDDQSAETHSHK.QS197MS2, MS3Basophilic
R.GKDSYETSQLDDQ(S*)AETHSHK.QS207MS2, MS3Acidophilic
NP_057319G protein–coupled receptor, family C, group 5, member B precursorGPRC5BMetabotropic glutamate, GABA-B–like receptor activity Receptor activity Sevenless binding
R.SNVYQPTEMAVVLNGG(T*)IPTAPPSHTGR.HT389YesMS2Basophilic
NP_000477Aquaporin 2AQP2Transporter activity Water channel activity
R.RQ(S*)VELHSPQSLPR.GS256NoMS2, MS3Basophilic
NP_004860Vacuolar protein sorting factor 4BVPS4BATP binding ATPase activity, Coupled nucleotide binding Protein binding
K.EGQPSPADEKGND(S*)DGEGESDDPEKKK.LS102YesMS2Acidophilic
NP_054762Chromatin modifying protein 2BCHMP2BNot classified
K.ATI(S*)DEEIER.QS199NoMS2, MS3 (unfiltered)Acidophilic
NP_687033Proteasome α 3 subunit isoform 2PSAM3Protein binding Threonine endopeptidase activity
K.ESLKEEDE(S*)DDDNMS243NoMS2, MS3Acidophilic
NP_036382Related RAS viral (r-ras) oncogene homolog 2RRAS2GTP binding Nucleotide binding Protein binding
R.KFQEQECPP(S*)PEPTRK.ES186YesMS2, MS3Proline-directed
NP_031381Heat-shock 90-kD protein 1, βHSP90AB1ATP binding Nitric-oxide synthase regulator activity Nucleotide binding TPR domain binding Unfolded protein binding
K.IEDVG(S*)DEEDDSGKDKK.KS255NoMS2Acidophilic
NP_612433Kinesin family member 12KIF12ATP binding Microtubule motor activity Nucleotide binding
R.VTTRPQAPK(S*)PVAK.QS236YesMS2, MS3Proline-directed
NP_079119Cytochrome b reductase 1CYBRD1Ferric-chelate reductase activity
R.NLALDEAGQRS(T*)M.T285YesMS2Basophilic
NP_001037857Mucin 1 isoform 7 precursorMUC1NF-κB binding protein heterodimerization activity
R.DTYHPMSEYPTYH(T*)HGR.YT118YesMS2, MS3 (unfiltered)AcidophilicProtein homodimerization activity RNA binding Tat protein binding Unfolded protein binding
NP_000330Solute carrier family 12 (sodium/chloride transporters), member 3SLC12A3Sodium ion binding Sodium:chloride
R.GARP(S*)VSGALDPK.AS811YesMS2Basophilicsymporter activity Symporter activity Transporter activity
NP_000329Sodium potassium chloride co-transporter 2SLC12A1Potassium ion binding Sodium ion binding
K.IEYYRN(T*)GSISGPK.VT118NoMS2, MS3N/ASodium:potassium:chloride symporter activity
K.IEYYRNTG(S*)ISGPK.VS120NoMS2, MS3BasophilicSymporter activity Transporter activity
Table contains phosphopeptides found in urinary exosomes. MS refers to spectra for phosphorylation site identification, Motif refers to phosphorylation motif site and GO Function.

A new phosphorylation site was also identified in the COOH-terminal tail of the thiazide-sensitive co-transporter (NCC) at S811 (Figure 2). This site is distinct from the N-terminal site previously identified14 and may play a role in regulation of transport. This amino acid is conserved in humans, chimpanzees, rhesus monkeys, and horses but not in mice and rats. Simon et al.15 showed that, in rat, the amino acid sequence surrounding this site is absent owing to a difference in exon splicing.

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Novel phosphorylation site in the NCC. The serine-811 on the NCC protein is phosphorylated. (A) The phosphorylation site on the peptide is denoted by an asterisk (*). (B) The neutral loss peak (NL) from the +2 mass spectrum and the site-determining ions b5, b6, y7, and y8.

Novel phosphorylation sites were also identified in RRAS2 (TC21), VPS4B (an ESCRT component), cytochrome b reductase, proteasome α 3 subunit, and mucin 1. This study also revealed previously identified phosphorylation sites in AQP2 (S256),16 NKCC2 (T118 and S120),17 CHMP2B (S199),18 HSP90AB1 (S255),19 and SPP1 (S192, S197, and S207).20 Phosphorylation of AQP2 at S256 was confirmed by immunoblotting human urinary exosomes samples with a phospho-specific antibody for this site (Figure 3).

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Detection of AQP2-S256 phosphorylation in urinary exosomes. IMCD, rat inner medullary collecting duct treated with dDAVP (V2R-selective vasopressin analog) for 30 min; exo (10 μg), is human urinary exosomes, 10 μg; exo (72 μg), human urinary exosomes, 72 μg.

Large-Scale Proteomic Profiling of Human Urinary Exosomes

In this study, we carried out proteomic profiling of a low-density membrane fraction from human urine consisting chiefly of exosomes, using a highly sensitive LC-MS/MS system, based on an ion trap mass spectrometer (LTQ; Thermo-Finnigan; Thermo Electron, San Jose, CA). We unambiguously identified 1132 proteins including 205 proteins seen in our previous study and 927 proteins not seen in our previous study of human urinary exosomes.1 The full list (ambiguous and unambiguous identifications) contains 1412 proteins and can be viewed in Supplemental Table 1, and the list of proteins that were unambiguously identified in both studies can be viewed at http://dir.nhlbi.nih.gov/papers/lkem/exosome/. The expanded list of exosomal proteins includes 177 proteins that are disease related, on the basis of their presence in the OMIM database (Table 1).

Table 1.

Disease-related proteins in human urinary exosomesa

GeneProtein NamePepIDRelated to Disease [OMIM]
ABCB1ATP-binding cassette subfamily B, member 12361Colchicine resistance [MIM: 120080] Crohn disease [MIM: 266600]
ABCC9ATP-binding cassette, subfamily C, member 9 isoform SUR2A-δ-1412Cardiomyopathy [MIM: 608569]
ABCB11ATP-binding cassette, subfamily B (MDR/TAP), member 1113Cholestasis, progressive familial intrahepatic 2 [MIM: 601847]
Cholestasis, benign recurrent intrahepatic 2 [MIM: 605479]
ACAT1Acetyl-CoA acetyltransferase 1 precursor12α-Methylacetoacetic aciduria [MIM: 203750]
ACEAngiotensin I–converting enzyme isoform 1 precursor2396Hypertension [MIM: 106180]
ACEAngiotensin I–converting enzyme isoform 2 precurs1261Renal tubular dysgenesis [267430]
ACE2Angiotensin I–converting enzyme 2 precursor817Hypertension [MIM: 300335]
ACOT7Acyl-CoA thioesterase 7 isoform hBACHd11Mesial temporal lobe epilepsy [MIM: 608096]
ACSL4Acyl-CoA synthetase long-chain family member 4 isoform 212Mental retardation, X-linked 63, MRX 63 [MIM: 300387]
ACY1Aminoacylase 11543Aminoacylase 1 deficiency [MIM: 609924]
AHCYS-adenosylhomocysteine hydrolase1028Hypermethioninemia [MIM: 180960]
AK1Adenylate kinase 144Hemolytic anemia due to AK1 deficiency [MIM: 103000]
ALADδ-Aminolevulinic acid dehydratase isoform a11Acute hepatic porphyria [MIM: 125270]
ALBAlbumin precursor36139Dysalbuminemic hyperthyroxinemia Hyperthyroxinemia, dysalbuminemic analbuminemia bisalbuminemia [MIM: 103600]
ALDOAAldolase A714Aldolase deficiency of red cells Myopathy and hemolytic anemia [MIM: 103850]
ALPLTissue nonspecific alkaline phosphatase precursor34Hypophostasia [MIM: 241500]
AMNAmnionless protein precursor11Megaloblastic anemia 1 [MIM: 261100]
ANPEPMembrane alanine aminopeptidase precursor69412Hypertension [MIM: 151530]
APOA1Apolipoprotein A-I preproprotein617Primary hypoalphalipoproteinemia [MIM: 604091]
APOA2Apolipoprotein A-II preproprotein11Apolipoprotein A-II deficiency, familial
Hypercholesterolemia, familial [MIM: 143890]
APRTAdenine phosphoribosyltransferase isoform a222,8-Dihydroxyadenine urolithiasis [MIM: 102600]
APRTAdenine phosphoribosyltransferase isoform b3102,8-Dihydroxyadenine urolithiasis [MIM: 102600]
AQP1Aquaporin 1335Aquaporin 1 deficiency, Colton-Null [MIM: 110450]
AQP2Aquaporin 2736Autosomal recessive nephrogenic diabetes insipidus, type 1 [MIM: 222000]Autosomal dominant nephrogenic diabetes insipidus, type 1 [MIM: 125800]
ARL6ADP-ribosylation factor–like 647Bardet-Biedl syndrome 3 [MIM: 209900]
ARSEArylsulfatase E precursor12Chondrodysplasia punctata 1, X-linked recessive [MIM: 302950]
ASAH1N-acylsphingosine amidohydrolase (acid ceramidase) 1 preproprotein isoform a716Farber disease [MIM: 228000]
ASAH1N-acylsphingosine amidohydrolase (acid ceramidase) 1 isoform b934Farber disease [MIM: 228000]
ASLArgininosuccinate lyase isoform 311Argoninosuccinic aciduria [MIM: 207900]
ASS1Argininosuccinate synthetase 12059Citrullinemia [MIM: 215700]
ATIC5-Aminoimidazole-4-carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase11Aica-ribosiduria due to ATIC deficiency [MIM: 608688]
ATP6V0A4ATPase, H transporting, lysosomal V0 subunit a412Renal tubular acidosis, distal, autosomal recessive [MIM: 602722]
ATP6V1B1ATPase, H transporting, lysosomal 56/58-kD, V1 subunit B1817Renal tubular acidosis, distal, with progressive deafness [MIM: 267300]
B2Mβ2-Microglobulin precursor11Hypercatabolic hypoproteinemia [MIM: 241600]
B4GALT1UDP-Gal:βGlcNAc β 1,4- galactosyltransferase 1, membrane-bound form11Congenital disorder of glycosylation type IId [MIM: 607091]
CA2Carbonic anhydrase II925Autosomal recessive syndrome of osteopetrosis with renal tubular acidosis [MIM: 259730]
CA4Carbonic anhydrase IV precursor22Proximal renal tubular acidosis [MIM: 114760]
CC2D1ACoiled-coil and C2 domain containing 1A66Mental retardation autosomal recessive 3 [MIM: 608443]
CD2APCD2-associated protein1421Focal segmental glomerulosclerosis FSGS3 [MIM: 607832]
CETPCholesteryl ester transfer protein, plasma precursor714Cholesterol ester transfer protein deficiency [MIM: 607322]
CFHComplement factor H isoform b precursor11Hemolytic uremic syndrome, atypical [MIM: 235400]
CFIComplement factor I11Complement factor I deficiency [MIM: 610984]
CHMP2BChromatin modifying protein 2B415Frontotemporal dementia, chromosome 3-linked [MIM: 6000795]
CLTCClathrin heavy chain 11224Renal cell carcinoma [MIM: 118955]
COL18A1α 1 type XVIII collagen isoform 1 precursor11Knobloch syndrome [MIM: 267750]
COL6A1Collagen, type VI, α 1 precursor621Bethlem myopathy [MIM: 158810] Ullrich congenital muscular dystrophy, autosomal dominant [MIM: 254090]
COL6A3α 3 type VI collagen isoform 5 precursor12Ullrich congenital muscular dystrophy [MIM: 254090]
CPCeruloplasmin precursor615Aceruloplasminemia [MIM: 604290]
CRYABCrystallin, α B712α-B crystallinopathy [MIM: 608810]
CRYMCrystallin, μ isoform 113Autosomal dominant nonsyndromic deafness [MIM: 123740]
CST3Cystatin C precursor13Icelandic-type cerebroarterial amyloidosis [MIM: 105150]
CSTBCystatin B210Myoclonic epilepsy of Unverricht and Lundborg [MIM: 254800]
CTSCCathepsin C isoform b precursor11Papillo-LeFevre syndrome [MIM: 245000]
CTHCystathionase isoform 211Cystathioninuria [MIM: 219500]
CTSACathepsin A precursor315Galactosialidosis [MIM: 256540]
CTSCCathepsin C isoform a preproprotein12Papillon-Lefevre syndrome [MIM: 245000]
CTSDCathepsin D preproprotein12Neuronal ceroid lipofuscinosis [MIM: 610127]
CTNSCystinosis, nephropathic isoform 113Nephropathic cystinosis [MIM: 219800]
CUBNCubilin104672Megaloblastic anemia 1, Finnish type [MIM: 261100]
CUL4BCullin 4B11Cabezas syndrome [MIM: 300354]
Mental retardation-hypotonic facies syndrome [MIM: 300639]
DDAH1Dimethylarginine dimethylaminohydrolase 115Hypertension [MIM: 604743]
DDCDopa decarboxylase (aromatic l-amino acid decarboxylase)1131Aromatic L-amino acid decarboxylase deficiency [MIM: 608643]
DNM2Dynamin 2 isoform 311Charcot-Marie-Tooth disease,
Dominant intermediate B [MIM: 606482]
DNM2Dynamin 2 isoform 411Charcot-Marie-Tooth neuropathy,
Dominant intermediate B [MIM: 606482]
DYSFDysferlin11Miyoshi myopathy [MIM: 254130]
DPYSDihydropyrimidinase56Dihydropyrimidinuria [MIM: 222748]
DSC2Desmocollin 2 isoform Dsc2b preproprotein13Arrhythmogenic right ventricular dysplasia-11 [MIM: 610476]
DSPDesmoplakin isoform II1016Keratosis palmoplantaris striata II dilated cardiomyopathy with woolly hair and keratoderma [MIM: 605676]
ECE1Endothelin-converting enzyme 111Hirschsprung disease [MIM: 142623]
EFEMP1EGF-containing fibulin–like extracellular matrix protein 1 precursor13Doyne Honeycomb retinal dystrophy [MIM: 126600]
ELA2Elastase 2, neutrophil preproprotein11Cyclic hematopoiesis [MIM: 162800]
ENPEPGlutamyl aminopeptidase (aminopeptidase A)25100Hypertension [MIM: 138297]
FAHFumarylacetoacetate hydrolase (fumarylacetoacetase)22Tyrosinemia type I [MIM: 276700]
FLNBFilamin B, β (actin-binding protein 278)11Spondylocarpotarsal synostosis syndrome [MIM: 272460]
FBP1Fructose-1,6-bisphosphatase 1716Fructose-1,6-bisphosphatase deficiency [MIM: 229700]
FGAFibrinogen, α polypeptide isoform α-E preproprotein517Renal amyloidosis [MIM: 105200] Dysfibrinogenemia [MIM: 134820]
FGGFibrinogen, γ chain isoform γ-A precursor11Dysfibrinogenemia[MIM: 134850]
FTCDFormiminotransferase cyclodeaminase47Glutamate formiminotransferase deficiency [MIM: 229100]
FTH1Ferritin, heavy polypeptide 117Iron overload, autosomal dominant [MIM: 134770]
FTLFerritin, light polypeptide514Hyperferritinemia-cataract syndrome [MIM: 600886]
FUCA1Fucosidase, α-L-1, tissue11Fucosidosis [MIM: 230000]
FXYD2FXYD domain–containing ion transport regulator 2 isoform 117Hypomagnesemia 2, renal [MIM: 154020]
G6PDGlucose-6-phosphate dehydrogenase isoform a11Nonspherocytic hemolytic anemia due to G6PD deficiency [MIM: 305900]
GAAAcid α-glucosidase preproprotein48Infantile-onset glycogen storage disease Type II [MIM: 232300]
GALK1Galactokinase 111Galactokinase deficiency [MIM: 230200]
GBE1Glucan (1,4-α-), branching enzyme 112Type IV glycogen storage disease [MIM: 232500]
GCS1Mannosyl-oligosaccharide glucosidase11Congenital disorder of glycosylation [MIM: 606056]
GKGlycerol kinase isoform a11Glycerol kinase deficiency [MIM: 307030]
GLB1Galactosidase, β 1 isoform a1670Gangliosidosis GM1 [MIM: 230500]
GLULGlutamine synthetase22Congenital glutamine deficiency [MIM: 610015]
GM2AGM2 ganglioside activator precursor23Gangliosidosis GM2 AB variant Tay-Sachs disease [MIM: 272750]
GPIGlucose phosphate isomerase919Chronic hemolytic anemia duet to GPI deficiency [MIM: 172400]
GPR98G protein–coupled receptor 98 precursor11Familial febrile seizures [MIM: 604352] Usher syndrome type IIC [MIM: 605472]
GSNGelsolin isoform b1021Finnish type familial amyloidosis [MIM: 105120]
GSSGlutathione synthetase13Glutathione synthetase deficiency [MIM: 266130]
HNMTHistamine N-methyltransferase isoform 111Susceptibility to asthma [MIM: 600807]
HPD4-Hydroxyphenylpyruvate dioxygenase11Tyrosinemia type III [MIM: 276710]
HPGDHydroxyprostaglandin dehydrogenase 15-(NAD)621Hypertension [MIM: 601688]
HSPG2Heparan sulfate proteoglycan 21841Schwartz-Jampel syndrome type 1 [MIM: 255800]
HSPB1Heat-shock 27-kD protein 1830Charcot-Marie-Tooth disease, type 2F [MIM: 606595] Distal hereditary motor neuropathy IIB [MIM: 608634]
ICAM1Intercellular adhesion molecule 1 precursor11Graves disease [MIM: 275000]
IL1RNInterleukin 1 receptor antagonist isoform 1 precursor22Gastric cancer risk [MIM: 137215]
IRF6Interferon regulatory factor 611Van der Woude syndrome [MIM: 119300] Popliteal pterygium syndrome [MIM: 119500]
ITM2BIntegral membrane protein 2B521Familial dementia [MIM: 176500]
JUPJunction plakoglobin915Naxos disease [MIM: 601214]
KALRNKalirin, RhoGEF kinase isoform 311Coronary heart disease [MIM: 608901]
KHKKetohexokinase isoform a24Essential fructosuria [MIM: 229800]
KLKlotho11Hyperphosphatemic tumoral calcinosis [MIM: 211900]
KLK1Kallikrein 1 preproprotein11Decreased urinary activity of kallikrein [MIM: 147910]
LGALS3Galectin 311Lymphocyte function–associated antigen 1 [MIM: 116920]
LAMP2Lysosomal-associated membrane protein 2 precursor426Danon disease [MIM: 300257]
LRRK2Leucine-rich repeat kinase 245Parkinson disease [MIM: 607060]
LYZLysozyme precursor13Familial visceral amyloidosis [MIM: 105200]
MIFMacrophage migration inhibitory factor (glycosylation-inhibiting factor)16Rheumatoid arthritis [MIM: 604302]
MMEMembrane metallo-endopeptidase neprilysin48311HypertensionImportant cell surface marker in the diagnostic of human acute lymphocytic leukemia [MIM: 120520]
MPOMyeloperoxidase732Myeloperoxidase deficiency [MIM: 254600]
MTHFD1Methylenetetrahydrofolate dehydrogenase 145Spina bifida [MIM: 601634]
MYH14Myosin, heavy chain 14 isoform 111Autosomal dominant nonsyndromic sensorineural deafness [MIM: 600652]
MYH3Myosin, heavy chain 3, skeletal muscle, embryonic11Freeman-Sheldon syndrome [MIM: 193700]
MYH9Myosin, heavy polypeptide 9, nonmuscle1951Fechtner syndrome [MIM: 153640]Epstein syndrome [MIM: 153650]
MYO15AMyosin XV13Recessive congenital deafness [MIM: 600316]
MYO6Myosin VI721Autosomal recessive congenital sensorineural deafness [MIM: 607821] Autosomal dominant nonsyndromic sensorineural deafness [MIM: 606346]
NAGLUα-N-acetylglucosaminidase precursor2163Mucopolysaccharidosis type IIIB [MIM: 252920]
NDRG1N-myc downstream regulated gene 125Charcot-Marie-Tooth disease type 4D [MIM: 601455]
NEBNebulin24Nemaline myopathy [MIM: 256030]
NPHS2Podocin69Autosomal recessive steroid-resistant nephrotic syndrome [MIM: 600995]
PAFAH1B1Platelet-activating factor acetylhydrolase, isoform Ib, α subunit (45 kD)11Miller-Dieker lissencephaly syndrome [MIM: 607432]
PARK7DJ-1 protein11Parkinson disease 7, autosomal recessive [MIM: 606324]
PCBD1Pterin-4 α-carbinolamine dehydratase precursor11Hyperphenylalaninemia [MIM: 264070]
PDCD10Programmed cell death 1023Cerebral cavernous malformations [MIM: 603285]
PHGDHPhosphoglycerate dehydrogenase22Phosphoglycerate dehydrogenase deficiency [MIM: 601815]
PKD1Polycystin 111Polycystic kidney disease, adult, type I [MIM: 601313]
PKD2Polycystin 212Polycystic kidney disease, adult, type II [MIM: 173910]
PKHD1Polyductin isoform 269Autosomal recessive polycystic kidney disease [MIM: 263200]
PKLRPyruvate kinase, liver, and RBC isoform 111Pyruvate kinase deficiency [MIM: 266200]
PLOD1Lysyl hydroxylase precursor11Ehlers-Danlos syndrome, type VIA [MIM: 225400]
PRKCHProtein kinase C, η12Cerebral infarction [MIM: 601367]
PROM1Prominin 123174Autosomal recessive retinal degeneration [MIM: 604365]
PRNPPrion protein preproprotein11Creutzfeldt-Jakob disease [MIM: 123400]
PSAPProsaposin isoform a preproprotein36Metachromatic leukodystrophy due to SAP1 deficiency [MIM: 249900]
Gaucher disease, atypical due to SAP2 deficiency [MIM: 610539]
PSAPProsaposin isoform c preproprotein14Metachromatic leukodystrophy [MIM: 249900]
PSAT1Phosphoserine aminotransferase isoform 124Phosphoserine aminotransferase deficiency [MIM: 610992]
PTPRJProtein tyrosine phosphatase, receptor type, J precursor11Somatic colon cancer [MIM: 114500]
RAB3GAP1RAB3 GTPase-activating protein11Warburg micro syndrome [MIM: 600118]
RBP4Retinol-binding protein 4, plasma precursor23Retinol-binding protein deficiency [MIM: 180250]
RDXRadixin1623Autosomal recessive deafness 24 [MIM: 611022]
ROBO2Roundabout, axon guidance receptor, homolog 211Vesicoureteral reflux 2 [MIM: 610878]
RP2XRP2 protein35X-linked retinitis pigmentosa 2 [MIM: 312600]
RYR1Skeletal muscle ryanodine receptor isoform 111Malignant hyperthermia [MIM: 145600] Central core disease [MIM: 117000] Minicore myopathy with external ophthalmoplegia [MIM: 255320]
SERPING1Complement component 1 inhibitor precursor714Hereditary angioedema type I [MIM: 106100]
SLC3A1Solute carrier family 3, member 11425Cystinuria [MIM: 220100]
SLC4A1Solute carrier family 4, anion exchanger, member 1 [kAE1]22Defective kidney acid secretion leading to distal renal tubular acidosis [MIM: 179800]
SLC4A4Solute carrier family 4, sodium bicarbonate co-transporter, member 4 [NBC1]23Renal tubular acidosis, proximal, with ocular abnormalities [MIM: 604278]
SLC5A1Solute carrier family 5 (sodium/glucose co-transporter), member 1 [SGLT1]23Glucose/galactose malabsorption [MIM: 606824]
SLC5A2Solute carrier family 5 (sodium/glucose co-transporter), member 2 [SGLT2]49Renal glucosuria [MIM: 233100]
SLC6A19Solute carrier family 6, member 1948Hartnup disorder [MIM: 234500]
SLC12A1Sodium potassium chloride co-transporter 2 [NKCC2]2594Bartter syndrome, antenatal, type 1 [MIM: 601678]
SLC12A3Solute carrier family 12 (sodium/chloride transporters), member 3 [NCC]28102Gitelman syndrome [MIM: 263800]
SLC22A12Urate anion exchanger 1 isoform a [URAT1]12Renal hypouricemia [MIM: 220150]
SLC25A3Solute carrier family 25 member 3 isoform b precursor15Mitochondrial phosphate carrier deficiency [MIM: 610773]
SLC26A4Pendrin24Pendred syndrome [MIM: 274600]Deafness, autosomal recessive 4 [MIM: 600791]
SLC44A4NG22 protein isoform 1659Sialidosis 1 [MIM: 606107]
SPRSepiapterin reductase (7,8-dihydrobiopterin:NADP + oxidoreductase)12Dystonia, dopa-responsive, due to sepiapterin reductase deficiency [MIM: 251120]
SQSTM1Sequestosome 112Paget disease of bone [MIM: 602080]
SUCLA2Succinate-CoA ligase, ADP-forming, β subunit11Mitochondrial DNA depletion syndrome [MIM: 609560]
TECTATectorin α precursor11Autosomal dominant nonsyndromic sensorineural hearing loss [MIM: 601842]
TFTransferrin1220Alzheimer disease [MIM: 104300]
TPP1Tripeptidyl-peptidase I preproprotein842Ceroid lipofuscinosis neuronal 2 [MIM: 204500]
TSG101Tumor susceptibility gene 1011766Breast cancer [MIM: 176960]
TTNTitin isoform novex 145Cardiomyopathy [MIM: 188840]
UMODUromodulin precursor351278Medullary cystic kidney disease-2 (MCKD2) [MIM: 603860]Familial juvenile hyperuricemic nephropathy (FJHN) [MIM: 16200]
VCPValosin-containing protein22Inclusion body myopathy with early-onset Paget disease and frontotemporal dementia [MIM: 167320]
VAMP7Vesicle-associated membrane protein 711β-Ureidopropionase deficiency [MIM: 606673]
VCLVinculin isoform meta-VCL35Cardiomyopathy, dilated [MIM: 611407]
VWFVon Willebrand factor preproprotein14Von Willebrand disease [MIM: 193400]
ZMPSTE24Zinc metalloproteinase STE2411Mandibuloacral dysplasia [MIM: 608612]
Information for each protein include “Gene” name, “Protein Name”, “Pep” refers to the number of unique peptides identified in LC-MS/MS, “ID” refers to the number of spectra and “Related to Disease [OMIM]” refers to the disease with which the protein is related according to OMIM. The 34 proteins associated with kidney diseases are presented in italics.

Predictably, a large number of proteins that were identified were integral membrane proteins involved in solute and water transport (Table 2). As seen in our previous study,1 these proteins predominantly represent apical transporters present in every renal tubule segment, including the proximal tubule (sodium-hydrogen exchanger 3, sodium-glucose co-transporter 1 and 2, and aquaporin-1 [AQP1]), the thick ascending limb (sodium-potassium-chloride co-transporter 2 [NKCC2]), the distal convoluted tubule (thiazide-sensitive Na-Cl co-transporter [NCC]), and connecting tubule/collecting duct (AQP2, rhesus blood group C glycoprotein [RhCG, an ammonia channel], B1 subunit of vacuolar H-ATPase, and pendrin). Note that both polycystin-1 and polycystin-2 were detected in human urinary exosomes.

Table 2.

Solute and water transportersa

Ref SeqGeneProtein NamePepID
NP_000918ABCB1ATP-binding cassette, subfamily B, member 12361
NP_003733ABCB11ATP-binding cassette, subfamily B (MDR/TAP), member 1113
NP_005680ABCB6ATP-binding cassette, subfamily B, member 611
NP_064694ABCC9ATP-binding cassette, subfamily C, member 9 isoform SUR2A-δ-1412
NP_149163ABCC11ATP-binding cassette, subfamily C, member 11 isoform a11
NP_932766AQP1Aquaporin 1335
NP_000477AQP2Aquaporin 2736
NP_000692ATP1A1Na/K-ATPase α 1 subunit isoform a proprotein1957
NP_001001787ATP1B1Na/K-ATPase β 1 subunit isoform b11
NP_001001937ATP5A1ATP synthase, H transporting, mitochondrial F1 complex, α subunit precursor35
NP_001677ATP5BATP synthase, H transporting, mitochondrial F1 complex, β subunit precursor45
NP_001174ATP6AP1ATPase, H transporting, lysosomal accessory protein 1 precursor11
NP_001685ATP6V0CATPase, H transporting, lysosomal, V0 subunit c19
NP_005168ATP6V0A1ATPase, H transporting, lysosomal V0 subunit a isoform 111
NP_065683ATP6V0A4ATPase, H transporting, lysosomal V0 subunit a412
NP_004682ATP6V0D1ATPase, H transporting, lysosomal, V0 subunit d111
NP_689778ATP6V0D2ATPase, H transporting, lysosomal 38 kD, V0 subunit D224
NP_001681ATP6V1AATPase, H transporting, lysosomal 70 kD, V1 subunit A, isoform 12249
NP_001683ATP6V1B1ATPase, H transporting, lysosomal 56/58 kD, V1 subunit B1817
NP_001684ATP6V1B2Vacuolar H-ATPase B21227
NP_001686ATP6V1C1ATPase, H transporting, lysosomal 42 kD, V1 subunit C1 isoform A11
NP_001034451ATP6V1C2Vacuolar H-ATPase C2 isoform a11
NP_057078ATP6V1DH-transporting two-sector ATPase23
NP_001687ATP6V1E1Vacuolar H-ATPase E1 isoform a22
NP_001034456ATP6V1E1Vacuolar H-ATPase E1 isoform c11
NP_001034455ATP6V1E1Vacuolar H-ATPase E1 isoform b11
NP_004222ATP6V1FATPase, H transporting, lysosomal 14 kD, V1 subunit F11
NP_004879ATP6V1G1Vacuolar H-ATPase G112
NP_998784ATP6V1HATPase, H transporting, lysosomal 50/57 kD, V1 subunit H isoform 1834
NP_036415KCNG2Potassium voltage-gated channel, subfamily G, member 212
NP_853514PKD1L3Polycystin 1–like 311
NP_001009944PKD1Polycystin 1 isoform 1 precursor11
NP_000288PKD2Polycystin 212
NP_057405RHCGRhesus blood group, C glycoprotein58
NP_000531RYR1Skeletal muscle ryanodine receptor isoform 111
NP_006505SCN10ASodium channel, voltage-gated, type X, α111
NP_054858SCN11ASodium channel, voltage-gated, type XI, α11
NP_000329SLC12A1Sodium potassium chloride co-transporter 22594
NP_000330SLC12A3Solute carrier family 12 (sodium/chloride transporters), member 328102
NP_064631SLC12A9Solute carrier family 12 (potassium/chloride transporters), member 911
NP_003975SLC13A2Solute carrier family 13 (sodium-dependent dicarboxylate transporter), member 2510
NP_073740SLC13A3Solute carrier family 13 member 3 isoform a22
NP_001011554SLC13A3Solute carrier family 13 member 3 isoform b13
NP_004161SLC1A1Solute carrier family 1, member 136
NP_066568SLC15A2Solute carrier family 15 (H/peptide transporter), member 211
NP_060954SLC22A11Solute carrier family 22 member 1129
NP_653186SLC22A12Urate anion exchanger 1 isoform a12
NP_003049SLC22A2Solute carrier family 22 member 2 isoform a23
NP_003051SLC22A5Solute carrier family 22 member 511
NP_004781SLC22A6Solute carrier family 22 member 6 isoform a13
NP_695010SLC22A6Solute carrier family 22 member 6 isoform d11
NP_004245SLC22A8Solute carrier family 22 member 812
NP_005838SLC23A1Solute carrier family 23 (nucleobase transporters), member 1 isoform a46
NP_689898SLC23A1Solute carrier family 23 (nucleobase transporters), member 1 isoform b610
NP_005975SLC25A1Solute carrier family 25 (mitochondrial carrier; citrate transporter), member 111
NP_998776SLC25A3Solute carrier family 25 member 3 isoform b precursor15
NP_775897SLC26A11Solute carrier family 26, member 1111
NP_000432SLC26A4Pendrin24
NP_003030SLC2A5Solute carrier family 2 (facilitated glucose/fructose transporter), member 51222
NP_775867SLC39A5Solute carrier family 39 (metal ion transporter), member 511
NP_000332SLC3A1Solute carrier family 3, member 11425
NP_001012679SLC3A2Solute carrier family 3 (activators of dibasic and neutral amino acid transport), member 2 isoform a1018
NP_002385SLC3A2Solute carrier family 3 (activators of dibasic and neutral amino acid transport), member 2 isoform c35
NP_536856SLC44A1CDW92 antigen11
NP_065161SLC44A2CTL2 protein1870
NP_000333SLC4A1Solute carrier family 4, anion exchanger, member 122
NP_003750SLC4A4Solute carrier family 4, sodium bicarbonate co-transporter, member 423
NP_000334SLC5A1Solute carrier family 5 (sodium/glucose co-transporter), member 123
NP_689564SLC5A10Solute carrier family 5 (sodium/glucose co-transporter), member 10 isoform 122
NP_001035915SLC5A10Solute carrier family 5 (sodium/glucose co-transporter), member 10 isoform 213
NP_848593SLC5A12Solute carrier family 5 (sodium/glucose co-transporter), member 12 isoform 224
NP_003032SLC5A2Solute carrier family 5 (sodium/glucose co-transporter), member 249
NP_666018SLC5A8Solute carrier family 5 (iodide transporter), member 811
NP_001011547SLC5A9Solute carrier family 5 (sodium/glucose co-transporter), member 913
NP_057699SLC6A13Solute carrier family 6 (neurotransmitter transporter, GABA), member 1311
NP_001003841SLC6A19Solute carrier family 6, member 1948
NP_004165SLC9A3Solute carrier family 9 (sodium/hydrogen exchanger), isoform 323
NP_004776SLC9A3R2Solute carrier family 9 isoform 3 regulator 211
NP_851322SLCO4C1Solute carrier organic anion transporter family, member 4C122
NP_003365VDAC1Voltage-dependent anion channel 1643
NP_005653VDAC3Voltage-dependent anion channel 311
Table contains all of the proteins that are solute and water transporters.

Exosomes derive from MVB and are delivered to the urine when the outer membranes of MVB fuse with the apical plasma membrane. Interestingly, 22 of the proteins identified in this study are recognized as components of the apparatus responsible for the formation of MVB (Table 3). These 22 proteins account for approximately 75% of the proteins that constitute the ESCRT-0, ESCRT-I, ESCRT-II, and ESCRT-III complexes involved in multivesicular body formation.5

Table 3.

Proteins of the ESCRT complex found in human urinary exosomesa

GeneProtein NamePepIDRef SeqESCRT Complex
HGSHepatocyte growth factor–regulated tyrosine kinase substrate11NP_004703ESCRT-0
TSG101Tumor susceptibility gene 1011547NP_006283ESCRT-I
VPS28Vacuolar protein sorting 28 isoform 158NP_057292ESCRT-I
VPS28Vacuolar protein sorting 28 isoform 228NP_898880ESCRT-I
VPS37BVacuolar protein sorting 37B410NP_078943ESCRT-I
VPS37CVacuolar protein sorting 37C11NP_060436ESCRT-I
VPS25EAP25415NP_115729ESCRT-II
VPS36EAP4523NP_057159ESCRT-II
SNF8EAP3011NP_009172ESCRT-II
CHMP2ACHMP2A640NP_055268ESCRT-III
CHMP2BCHMP2B311NP_054762ESCRT-III
VPS24CHMP313NP_057163ESCRT-III
VPS24CHMP314NP_001005753ESCRT-III
CHMP4BCHMP4B26NP_789782ESCRT-III
CHMP5CHMP527NP_057494ESCRT-III
CHMP1ACHMP1A13NP_002759ESCRT-III
CHMP1BCHMP1B12NP_065145ESCRT-III
CHMP6CHMP623NP_078867ESCRT-III
VPS4AVacuolar protein sorting factor 4A1125NP_037377ATPase complex
VPS4BVacuolar protein sorting factor 4B1132NP_004860ATPase complex
PDCD6IPALIX27104NP_037506Accessory
C1orf58Hypothetical protein LOC1483621134NP_653296Accessory
Table contains all of the proteins that are members of the ESCRT Complex (ESCRT-0, ESCRT-I, ESCRT-II, ESCRT-III, ATPase complex and accessory).

In addition, 17 proteins identified in this study are subunits of the human vacuolar H-ATPase (Table 4). Vacuolar H-ATPases are ATP-dependent proton pumps for proton transport into intracellular organelles.6 These proteins also mediate proton transport across the apical plasma membrane of type A intercalated cells and across the basolateral plasma membrane of type B intercalated cells.7 The B1 subunit is selectively expressed in intercalated cells, and its detection in urinary exosomes establish that intercalated cells secrete exosomes as do other types of epithelial cells lining the renal tubule. These proteins constitute 78% of the subunits of the V0 and V1 domains of the vacuolar H-ATPase.8

Table 4.

Vacuolar H-ATPase subunits in human urinary exosomesa

Ref SeqGeneProtein NamePepID
NP_005168ATP6V0A1ATPase, H transporting, lysosomal V0 subunit a isoform 111
NP_065683ATP6V0A4ATPase, H transporting, lysosomal V0 subunit a412
NP_001685ATP6V0CATPase, H transporting, lysosomal, V0 subunit c11
NP_004682ATP6V0D1ATPase, H transporting, lysosomal, V0 subunit d111
NP_689778ATP6V0D2ATPase, H transporting, lysosomal 38 kD, V0 subunit D224
NP_001681ATP6V1AATPase, H transporting, lysosomal 70 kD, V1 subunit A, isoform 12249
NP_001683ATP6V1B1ATPase, H transporting, lysosomal 56/58 kD, V1 subunit B1817
NP_001684ATP6V1B2vacuolar H-ATPase B21227
NP_001686ATP6V1C1ATPase, H transporting, lysosomal 42 kD, V1 subunit C1 isoform A11
NP_001034451ATP6V1C2vacuolar H-ATPase C2 isoform a11
NP_057078ATP6V1DH(+)-transporting two-sector ATPase23
NP_001687ATP6V1E1vacuolar H-ATPase E1 isoform a22
NP_001034455ATP6V1E1vacuolar H-ATPase E1 isoform b11
NP_001034456ATP6V1E1vacuolar H-ATPase E1 isoform c11
NP_004222ATP6V1FATPase, H transporting, lysosomal 14 kD, V1 subunit F11
NP_004879ATP6V1G1vacuolar H-ATPase G112
NP_998784ATP6V1HATPase, H transporting, lysosomal 50/57 kD, V1 subunit H isoform 1834
Table contains proteins that are found in human urinary exosomes and are subunits of the human vacuolar H-ATPase.

An example of the utility of exosome analysis is shown in Figure 1, describing immunoblotting in patients with Bartter syndrome type I, associated with mutations in the SLC12A1 gene, which encodes for the NKCC2 sodium-potassium-chloride co-transporter protein.9 The NKCC2 protein was found in the proteome of the human urinary exosomes as shown in Table 1. Urine samples were obtained from two patients (patients 1 and 2) with clinical phenotypes consistent with Bartter syndrome type I (Figure 1A).10 The clinical diagnosis for the patients with Bartter syndrome type I was confirmed by the ultrasound images showing deposits of calcium in the kidney also known as nephrocalcinosis910 (Figure 1B) and other typical laboratory findings. The two urinary exosome samples obtained from the patients with Bartter syndrome type I were analyzed by immunoblotting for the presence of the NKCC2 protein (Figure 1C). Compared with the respective control samples, patients 1 and 2 showed an absence of the NKCC2 protein bands, expected at 160 kD for monomeric NKCC2 and 320 kD for dimeric NKCC2. In addition, the samples (patients 1 and 2) were probed for the thiazide-sensitive co-transporter (NCC) protein to ensure that urinary exosomes were successfully isolated and loaded properly. Strong NCC bands were obtained in samples from both patients with Bartter syndrome type I and control samples.

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Disease-related protein: NKCC2 and Bartter syndrome type I. (A) Details of clinical phenotype for patients with Bartter syndrome type I, patient 1 and patient 2. (B) Ultrasound images showing calcium deposits (white arrowheads) in the kidneys of patients 1 and 2. (C) Immunoblot of urinary exosomes samples from patient 1, patient 2, control 1, and control 2 using polyclonal rabbit anti-NKCC2 and NCC antibodies.

Phosphoproteomic Analysis of Human Urinary Exosomes

Protein phosphorylation is a key element of most cell regulatory processes. Recently, technical approaches that allow phosphoproteomic profiling on a large scale have been introduced.41113 We used neutral loss scanning with high-stringency target-decoy analysis to identify phosphorylation sites present in exosomal proteins from human urine samples.

Nineteen phosphorylation sites corresponding to 14 phosphoproteins were identified (Table 5). These included both newly identified phosphorylation sites and sites that had been previously identified. Two orphan G-protein–coupled receptors are included in the former group, viz. GPRC5B and GPRC5C. In GPRC5B, we identified one new phosphorylation site, T389, and, in GPRC5C, we identified three new phosphorylation sites, T435, S395, and Y426. These proteins are also known as retinoic acid–induced gene 2 (GPRC5B) and retinoic acid–induced gene 3 (GPRC5C).

Table 5.

Human urinary exosome phosphopeptidesa

Ref SeqProtein Name, SequenceSiteGeneNovel SiteMSnMotifGO Function
NP_061123G protein–coupled receptor family C, group 5, member C isoform bGPRC5CMetabotropic glutamate, GABA-B–like receptor activity Protein binding Receptor activity
R.AEDMYSAQSHQAA(T*)PPKDGK.NT435YesMS2, MS3Proline-directed
K.VP(S*)EGAYDIILPR.AS395YesMS2, MS3Phosphoserine/threonine binding group
R.AEDM(Y*)SAQSHQAATPPKDGK.NY426YesMS2Tyrosine kinase
NP_001035149Secreted phosphoprotein 1 isoform cSPP1Cytokine activity Growth factor activity Integrin binding Protein binding
K.AIPVAQDLNAPSDWD(S*)R.GS192NoMS2Miscellaneous
R.GKD(S*)YETSQLDDQSAETHSHK.QS197MS2, MS3Basophilic
R.GKDSYETSQLDDQ(S*)AETHSHK.QS207MS2, MS3Acidophilic
NP_057319G protein–coupled receptor, family C, group 5, member B precursorGPRC5BMetabotropic glutamate, GABA-B–like receptor activity Receptor activity Sevenless binding
R.SNVYQPTEMAVVLNGG(T*)IPTAPPSHTGR.HT389YesMS2Basophilic
NP_000477Aquaporin 2AQP2Transporter activity Water channel activity
R.RQ(S*)VELHSPQSLPR.GS256NoMS2, MS3Basophilic
NP_004860Vacuolar protein sorting factor 4BVPS4BATP binding ATPase activity, Coupled nucleotide binding Protein binding
K.EGQPSPADEKGND(S*)DGEGESDDPEKKK.LS102YesMS2Acidophilic
NP_054762Chromatin modifying protein 2BCHMP2BNot classified
K.ATI(S*)DEEIER.QS199NoMS2, MS3 (unfiltered)Acidophilic
NP_687033Proteasome α 3 subunit isoform 2PSAM3Protein binding Threonine endopeptidase activity
K.ESLKEEDE(S*)DDDNMS243NoMS2, MS3Acidophilic
NP_036382Related RAS viral (r-ras) oncogene homolog 2RRAS2GTP binding Nucleotide binding Protein binding
R.KFQEQECPP(S*)PEPTRK.ES186YesMS2, MS3Proline-directed
NP_031381Heat-shock 90-kD protein 1, βHSP90AB1ATP binding Nitric-oxide synthase regulator activity Nucleotide binding TPR domain binding Unfolded protein binding
K.IEDVG(S*)DEEDDSGKDKK.KS255NoMS2Acidophilic
NP_612433Kinesin family member 12KIF12ATP binding Microtubule motor activity Nucleotide binding
R.VTTRPQAPK(S*)PVAK.QS236YesMS2, MS3Proline-directed
NP_079119Cytochrome b reductase 1CYBRD1Ferric-chelate reductase activity
R.NLALDEAGQRS(T*)M.T285YesMS2Basophilic
NP_001037857Mucin 1 isoform 7 precursorMUC1NF-κB binding protein heterodimerization activity
R.DTYHPMSEYPTYH(T*)HGR.YT118YesMS2, MS3 (unfiltered)AcidophilicProtein homodimerization activity RNA binding Tat protein binding Unfolded protein binding
NP_000330Solute carrier family 12 (sodium/chloride transporters), member 3SLC12A3Sodium ion binding Sodium:chloride
R.GARP(S*)VSGALDPK.AS811YesMS2Basophilicsymporter activity Symporter activity Transporter activity
NP_000329Sodium potassium chloride co-transporter 2SLC12A1Potassium ion binding Sodium ion binding
K.IEYYRN(T*)GSISGPK.VT118NoMS2, MS3N/ASodium:potassium:chloride symporter activity
K.IEYYRNTG(S*)ISGPK.VS120NoMS2, MS3BasophilicSymporter activity Transporter activity
Table contains phosphopeptides found in urinary exosomes. MS refers to spectra for phosphorylation site identification, Motif refers to phosphorylation motif site and GO Function.

A new phosphorylation site was also identified in the COOH-terminal tail of the thiazide-sensitive co-transporter (NCC) at S811 (Figure 2). This site is distinct from the N-terminal site previously identified14 and may play a role in regulation of transport. This amino acid is conserved in humans, chimpanzees, rhesus monkeys, and horses but not in mice and rats. Simon et al.15 showed that, in rat, the amino acid sequence surrounding this site is absent owing to a difference in exon splicing.

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Novel phosphorylation site in the NCC. The serine-811 on the NCC protein is phosphorylated. (A) The phosphorylation site on the peptide is denoted by an asterisk (*). (B) The neutral loss peak (NL) from the +2 mass spectrum and the site-determining ions b5, b6, y7, and y8.

Novel phosphorylation sites were also identified in RRAS2 (TC21), VPS4B (an ESCRT component), cytochrome b reductase, proteasome α 3 subunit, and mucin 1. This study also revealed previously identified phosphorylation sites in AQP2 (S256),16 NKCC2 (T118 and S120),17 CHMP2B (S199),18 HSP90AB1 (S255),19 and SPP1 (S192, S197, and S207).20 Phosphorylation of AQP2 at S256 was confirmed by immunoblotting human urinary exosomes samples with a phospho-specific antibody for this site (Figure 3).

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Detection of AQP2-S256 phosphorylation in urinary exosomes. IMCD, rat inner medullary collecting duct treated with dDAVP (V2R-selective vasopressin analog) for 30 min; exo (10 μg), is human urinary exosomes, 10 μg; exo (72 μg), human urinary exosomes, 72 μg.

DISCUSSION

Large-Scale Proteomic Profiling of Human Urinary Exosomes

One of the objectives of this study was to expand the existing human urinary exosome database by using a higher sensitivity LC-MS/MS mass spectrometer and improved computational tools for matching spectra to proteins in the human proteome. The LTQ mass analyzer has an increased trapping efficiency, ion capacity, and ion ejection rate compared with the LCQ mass analyzer1 used in our previous study. We identified the peptide sequences using the SEQUEST program and analyzed them using the target-decoy database search strategy and the InsPecT tool. The target-decoy database search strategy allows adjustment of SEQUEST search parameters to ensure a given false-discovery rate (FDR).13 The InsPecT tool uses de novo sequencing to generate tag filters, which are then used to search the database to “look for any peptide that matches the tag.”21 The data have been made available to the general public and can be downloaded from our laboratory's website (http://dir.nhlbi.nih.gov/papers/lkem/exosome/). In addition, the database can be searched using the BLAST algorithm.

As illustrated in Figure 1, analysis of human urinary exosomes by mass spectrometry and immunoblotting can provide information with regard to genetic diseases involving apical proteins as shown by the qualitative assessment of urinary exosome samples from patients with Bartter syndrome type I. The urinary exosome patient samples showed a complete absence of NKCC2 protein bands. Mutations in the SLC12A1 gene cause Bartter syndrome type I.9 Many such mutations presumably result in misfolding of the NKCC2 protein, preventing the apical delivery of the protein and therefore preventing incorporation into urinary exosomes.

Barriers to Clinical Use of Human Urinary Exosome Analysis

We previously reviewed the potential of urinary exosome analysis as a route to biomarker discovery in renal diseases and delineated barriers to success with the approach.22122 One important barrier is the lack of standard protocols for collection, processing, and storage of urine samples to allow reproducible measurements to be made in any clinical laboratory. We have proposed a set of procedures that can serve as a beginning point in the development of such techniques (http://intramural.niddk.nih.gov/research/uroprot/). Our current approach includes an ultracentrifugation step, which requires expensive instrumentation and long processing times. Filtration methods have been proposed to replace the ultracentrifugation step.3 A particular knotty problem is removal of Tamm-Horsfall protein, an extraordinary abundant urinary protein that interferes with successful mass spectrometry and immunoblotting.23 In the long run, the most important technical challenge may be to develop quantification approaches that allow detection of changes in excretion rates of particular biomarker candidates. Both labeling and nonlabeling methods have been developed to make protein mass spectrometry quantitative24; however, the biggest barrier to quantification lies in development of adequate normalization techniques providing surrogates for timed collections of urine, which are notoriously inaccurate.21 Use of creatinine as a normalizing variable may be inadequate because of high subject-to-subject variability in its rate of excretion.21 Even without quantification, urinary exosome analysis can be valuable in situations such as genetic diseases (e.g., Bartter syndrome type I [Figure 1]), where a protein may be entirely absent from urinary exosomes.

Relevance to Renal Biology

Several of the proteins newly identified in urinary exosomes in this study may have considerable relevance to renal biology and the mechanism of renal disease. Our previous study1 identified proteins that were characteristic of most of the cell types facing the urinary space from podocytes through transitional epithelial cells of the urinary drainage system. In this study, we identified markers of two additional cell types, type A and B intercalated cells. Specifically, the B1 subunit of the H-ATPase is apically located in type A intercalated cells,25 and the anion transporter pendrin is present in type B intercalated cells.26 Previously, we showed that urinary exosomes are derived from the apical endosomal pathway so that, although the B1 subunit of the H-ATPase is also expressed in type B intercalated cells, its basolateral location probably precludes delivery to urinary exosomes. Overall, we identified 17 different vacuolar H-ATPase subunits in urinary exosomes, 78% of the whole V0–V1 complex.8

We identified all of the subunits of the four ESCRT complexes (ESCRT-0 through ESCRT-III) in urinary exosomes in this study. The ESCRT complexes play a central role in the formation of MVB and the secretion of exosomes.5

Four different orphan G-protein–coupled receptors were identified in urinary exosomes in this study, namely GPR98, GPRC5A, GPRC5B, and GPRC5C. These receptors are presumably apically located in one or more renal tubule cells. GPR98 (also known as very large G-protein–coupled receptor 1 or Neurepin) has more than 6000 amino acids. The three GPRC5 proteins are members of the metabotropic glutamate family, but their natural ligands are unknown. It will be of interest in future studies to discover the role of these proteins in renal development and regulation.

Phosphoproteomic Analysis of Human Urinary Exosomes

Posttranslational modifications (PTM) of proteins play an important role in protein function. Among the most important PTM is phosphorylation. Protein phosphorylation regulates cellular signaling processes and may determine protein structure, function, and subcellular localization.12 The ability to detect PTM, such as phosphorylation, in urinary exosomes may provide an additional level of information that could aid in diagnosis and treatment of a variety of renal disorders. Furthermore, discovery of PTM in urinary exosomes can provide clues about physiologic and pathophysiologic mechanism. In this study, we identified 14 phosphoproteins. The specific phosphorylation sites identified included six that were previously identified and eight that had not been previously identified. Among the novel sites was serine-811 in the NCC protein. This amino acid is conserved in humans, chimpanzees, rhesus monkeys, and horses but not in mice and rats. The amino acid sequence surrounding this site is absent in rodents owing to a difference in exon splicing.15 Finally, AQP2 phosphorylated at serine-256 was readily detectable in urinary exosomes. Because this phosphorylation event is increased by vasopressin-stimulated activation of adenylyl cyclase,16 measurements of the amount of serine-256–phosphorylated AQP2 in urine may provide an improved means of assessing the state of vasopressin activation using phospho-specific antibodies.

Large-Scale Proteomic Profiling of Human Urinary Exosomes

One of the objectives of this study was to expand the existing human urinary exosome database by using a higher sensitivity LC-MS/MS mass spectrometer and improved computational tools for matching spectra to proteins in the human proteome. The LTQ mass analyzer has an increased trapping efficiency, ion capacity, and ion ejection rate compared with the LCQ mass analyzer1 used in our previous study. We identified the peptide sequences using the SEQUEST program and analyzed them using the target-decoy database search strategy and the InsPecT tool. The target-decoy database search strategy allows adjustment of SEQUEST search parameters to ensure a given false-discovery rate (FDR).13 The InsPecT tool uses de novo sequencing to generate tag filters, which are then used to search the database to “look for any peptide that matches the tag.”21 The data have been made available to the general public and can be downloaded from our laboratory's website (http://dir.nhlbi.nih.gov/papers/lkem/exosome/). In addition, the database can be searched using the BLAST algorithm.

As illustrated in Figure 1, analysis of human urinary exosomes by mass spectrometry and immunoblotting can provide information with regard to genetic diseases involving apical proteins as shown by the qualitative assessment of urinary exosome samples from patients with Bartter syndrome type I. The urinary exosome patient samples showed a complete absence of NKCC2 protein bands. Mutations in the SLC12A1 gene cause Bartter syndrome type I.9 Many such mutations presumably result in misfolding of the NKCC2 protein, preventing the apical delivery of the protein and therefore preventing incorporation into urinary exosomes.

Barriers to Clinical Use of Human Urinary Exosome Analysis

We previously reviewed the potential of urinary exosome analysis as a route to biomarker discovery in renal diseases and delineated barriers to success with the approach.22122 One important barrier is the lack of standard protocols for collection, processing, and storage of urine samples to allow reproducible measurements to be made in any clinical laboratory. We have proposed a set of procedures that can serve as a beginning point in the development of such techniques (http://intramural.niddk.nih.gov/research/uroprot/). Our current approach includes an ultracentrifugation step, which requires expensive instrumentation and long processing times. Filtration methods have been proposed to replace the ultracentrifugation step.3 A particular knotty problem is removal of Tamm-Horsfall protein, an extraordinary abundant urinary protein that interferes with successful mass spectrometry and immunoblotting.23 In the long run, the most important technical challenge may be to develop quantification approaches that allow detection of changes in excretion rates of particular biomarker candidates. Both labeling and nonlabeling methods have been developed to make protein mass spectrometry quantitative24; however, the biggest barrier to quantification lies in development of adequate normalization techniques providing surrogates for timed collections of urine, which are notoriously inaccurate.21 Use of creatinine as a normalizing variable may be inadequate because of high subject-to-subject variability in its rate of excretion.21 Even without quantification, urinary exosome analysis can be valuable in situations such as genetic diseases (e.g., Bartter syndrome type I [Figure 1]), where a protein may be entirely absent from urinary exosomes.

Relevance to Renal Biology

Several of the proteins newly identified in urinary exosomes in this study may have considerable relevance to renal biology and the mechanism of renal disease. Our previous study1 identified proteins that were characteristic of most of the cell types facing the urinary space from podocytes through transitional epithelial cells of the urinary drainage system. In this study, we identified markers of two additional cell types, type A and B intercalated cells. Specifically, the B1 subunit of the H-ATPase is apically located in type A intercalated cells,25 and the anion transporter pendrin is present in type B intercalated cells.26 Previously, we showed that urinary exosomes are derived from the apical endosomal pathway so that, although the B1 subunit of the H-ATPase is also expressed in type B intercalated cells, its basolateral location probably precludes delivery to urinary exosomes. Overall, we identified 17 different vacuolar H-ATPase subunits in urinary exosomes, 78% of the whole V0–V1 complex.8

We identified all of the subunits of the four ESCRT complexes (ESCRT-0 through ESCRT-III) in urinary exosomes in this study. The ESCRT complexes play a central role in the formation of MVB and the secretion of exosomes.5

Four different orphan G-protein–coupled receptors were identified in urinary exosomes in this study, namely GPR98, GPRC5A, GPRC5B, and GPRC5C. These receptors are presumably apically located in one or more renal tubule cells. GPR98 (also known as very large G-protein–coupled receptor 1 or Neurepin) has more than 6000 amino acids. The three GPRC5 proteins are members of the metabotropic glutamate family, but their natural ligands are unknown. It will be of interest in future studies to discover the role of these proteins in renal development and regulation.

Phosphoproteomic Analysis of Human Urinary Exosomes

Posttranslational modifications (PTM) of proteins play an important role in protein function. Among the most important PTM is phosphorylation. Protein phosphorylation regulates cellular signaling processes and may determine protein structure, function, and subcellular localization.12 The ability to detect PTM, such as phosphorylation, in urinary exosomes may provide an additional level of information that could aid in diagnosis and treatment of a variety of renal disorders. Furthermore, discovery of PTM in urinary exosomes can provide clues about physiologic and pathophysiologic mechanism. In this study, we identified 14 phosphoproteins. The specific phosphorylation sites identified included six that were previously identified and eight that had not been previously identified. Among the novel sites was serine-811 in the NCC protein. This amino acid is conserved in humans, chimpanzees, rhesus monkeys, and horses but not in mice and rats. The amino acid sequence surrounding this site is absent in rodents owing to a difference in exon splicing.15 Finally, AQP2 phosphorylated at serine-256 was readily detectable in urinary exosomes. Because this phosphorylation event is increased by vasopressin-stimulated activation of adenylyl cyclase,16 measurements of the amount of serine-256–phosphorylated AQP2 in urine may provide an improved means of assessing the state of vasopressin activation using phospho-specific antibodies.

CONCISE METHODS

Urinary Exosome Isolation

Urine was collected from eight healthy humans: Four men (aged 22 to 33) and four women (aged 24 to 35) (National Institute of Diabetes and Digestive and Kidney Diseases Clinical Research Protocol 00-DK-0107). Fifty milliliters per subject was collected and mixed together. The urinary exosome isolation procedure is shown in Figure 4. Protease inhibitors were added (1.67 ml of 100 mM NaN3, 2.5 ml of 11.5 mM 4-[2-aminoethyl] benzenesulfonyl fluoride, and 50 μl of 1 mM leupeptin). The mixed sample was centrifuged at 17,000 × g for 10 min at 4°C. The 17,000 × g supernatant was ultracentrifuged at 200,000 × g for 1 h at 25°C. The ultracentrifugation step was repeated 3 additional times, adding new 17,000 × g supernatant volume each time to each of the 12 tubes. Each of the 12 pellets was suspended with 50 μl of “isolation solution” (10 mM triethanolamine and 250 mM sucrose). The suspensions were pooled together.

An external file that holds a picture, illustration, etc.
Object name is asn0020938610004.jpg

Differential centrifugation procedure for the isolation of urinary exosomes from urine.

The abundant urinary protein uromodulin or Tamm-Horsfall protein forms very high molecular weight complexes through disulfide linkages. These complexes sediment in the 200,000 × g spin unless denatured. To denature the zona pellucida domains in the Tamm-Horsfall protein, we mixed the resuspended pellet with 200 mg/ml dithiothreitol (DTT) at 95°C for 2 min. The resuspended pellet was added to an ultracentrifuge tube, and isolation solution was added to increase the volume to 8 ml. The sample was centrifuged at 200,000 × g for 1 h at 25°C. The pellet was suspended in 50 μl of isolation solution and frozen at −80°C.

In-Gel Trypsin Digestion

The protein concentration was determined using the Bradford Assay. This sample was solubilized in Laemmli sample buffer (1.5% SDS, 6% glycerol/10 mM Tris HCl, and 60 mg/ml DTT). Proteins in the exosome sample were separated by 1D SDS-PAGE using a Bio-Rad Ready Gel 4 to 15% polyacrylamide gradient gel with 125 μg distributed among two lanes. The gel was stained with Colloidal Coomassie Blue (GelCode Blue Stain Reagent; Pierce, Rockford IL) for 10 min and destained using ddH2O (2 × 30 min). The gel was divided from top to bottom into 40 1-mm strips over the entire molecular weight range of the gel. Each strip was diced into small pieces (1 mm) and placed into labeled centrifuge tubes.

The gels pieces were destained by adding 100 μl of 25 mM ammonium bicarbonate (NH4HCO3)/50% acetonitrile (ACN) for 10 min and were dried using a SpeedVac. The samples were reduced in a solution of 10 mM DTT and 25 mM NH4HCO3 at 56°C for 1 h. The samples were alkylated in a solution containing 55 mM iodoacetamide and 25 mM NH4HCO3 in the dark at room temperature for 45 min. The gel pieces were washed with 25 mM NH4HCO3 and dehydrated in a solution containing 25 mM NH4HCO3 and 50% ACN. The samples were dried using the SpeedVac. The samples were rehydrated in a solution containing 12.5 ng/μl trypsin (V5113; Promega, Madison, WI) in 25 mM NH4HCO3 and digested overnight at 37°C. Peptides were extracted using 50% ACN/0.1% formic acid (FA). The extracted samples were dried using the SpeedVac to remove ACN and then reconstituted with 0.1% FA. All 40 peptide samples were desalted using C18 Zip Tips (Millipore, Billerica, MA) before analysis by mass spectrometry.

Nanospray LC-MS/MS

A high-sensitivity linear ion trap mass spectrometer, LTQ (Thermo Electron Corp.) equipped with a nanoelectrospray ion source was used to acquire m/z ratios in both precursor ions (MS1) and fragmented ions (MS2) scans. To reduce further the sample complexity before mass analysis, we injected the tryptic peptides extracted from each gel slice using an Agilent 1100 nanoflow system (Agilent Technologies, Palo Alto, CA) into a reversed-phase liquid chromatographic column (PicoFrit, Biobasic C18; New Objective, Woodburn, MA). This LC-MS/MS method allows the acquisition of raw data files that are the MS/MS scans of the five highest intensity peaks after fragmentation with collision-induced dissociation in the LTQ mass analyzer.

Analysis of Data

The raw data files were searched against the NCBI Reference Sequences (RefSeq) human protein database by using BIOWORKS software (Thermo Finnigan). BIOWORKS utilizes SEQUEST, which is a program that “finds database candidate sequences whose theoretical spectra are compared with the experimental spectrum.”27 To identify thoroughly peptide sequences, we searched the raw data files using the target-decoy approach and InsPecT.

In addition, we analyzed the data in a two-step process. The first step was to assess and minimize false-discovery peptide identifications using the target-decoy approach, manual inspection of spectra, and InsPecT. The second step was to assess and eliminate ambiguous protein identifications.

Target-Decoy

To apply the target-decoy database searching strategy,13 we used the NHLBI Proteomics Core Facility in-house software to create a composite database containing the forward and reverse sequences of the nonredundant NCBI Reference Sequences (RefSeq) human protein database released on January 26, 2007. We used the forward sequences as the target database and the reversed sequences as the decoy database. We searched the raw data files against this composite database. After the search, we assessed the FDR by the number of peptides matched from the reversed sequences. The parameters that determine the stringency of the filtering criteria include XCorr, Sp rank, and delta Cn. These parameters were incrementally adjusted, thereby reducing the false-discovery identifications until a target FDR was achieved. In our case, the data were filtered to a target of 2% FDR, and the actual FDR was 1.91%. The filter settings used were min Xcorr rank 1, min Sp rank 10, min delta Cn 0.08, charge + 1 min Xcorr 2.37, charge + 2 min Xcorr 2.87, and charge + 3 min Xcorr 3.37.

InsPecT

We performed an additional analysis of the tandem mass spectrometry data using the InsPecT tool.28 InsPecT uses de novo sequencing to generate sequence information (tag filters) from the experimental data. The tag filters are used to search the human protein database, nonredundant NCBI Reference Sequences (RefSeq) human protein database released on January 26, 2007, and identify peptide sequences that match with the experimental data. The size of the tag filters are three peptides in length on average. As shown in Figure 5, the tag filter generated for the protein CHMP1A matches the experimental data accurately. The peptide sequences identified using the tag filters are then scored to estimate that the top match is correct.28 The score procedure computes the P value for each peptide sequence by “comparing the match quality score to the distribution of quality scores for incorrect matches.” For these data, we accept only peptide matches with P ≤ 0.05.

An external file that holds a picture, illustration, etc.
Object name is asn0020938610005.jpg

Spectrum generated by InsPecT for CHMP1A protein (NP_002759). The peptide sequence is RVYAENAIRK. The tag region for the b ions and the y ions are shown by the black solid lines.

Minimizing False-Discovery Peptide Identifications

In addition to the target-decoy approach the InsPecT analysis, we validated the quality of proteins identified by manually checking the spectra of those proteins with one unique peptide. We filtered out the proteins that did not have the expected molecular weight that matched to the corresponding regions in the 1-D SDS PAGE.

Elimination of Ambiguous Protein Identifications

Once proteins were identified using the approaches described, we needed to determine whether all identifications corresponded to unique gene products. An “ambiguous identification” is defined as an identification for which the peptide sequence that is used to determine the protein identity is found in multiple proteins that are not splice variants of the same gene (Figure 6).

An external file that holds a picture, illustration, etc.
Object name is asn0020938610006.jpg

Criteria to disambiguate data set. (A) An unambiguous identification when a peptide sequence was a 100% match without gaps to one and only one protein. (B) An unambiguous identification when a peptide sequence was a 100% match without gaps to more than one protein, but these proteins are splice-variant products of one unique gene. (C) An ambiguous identification when a peptide sequence was a 100% match without gaps to more than one protein deriving from more than one gene, and the identification was based only on that single peptide.

To disambiguate the data set, we generated software that automates the comparison of each peptide sequence to the protein sequences in the RefSeq Human Protein Database using the BLAST algorithm. An identification was considered unambiguous when the sequence was a 100% match without gaps to one and only one protein (Figure 6A). An identification was also considered unambiguous when the sequence was a 100% match without gaps to more than one protein but these proteins are splice-variant products of one unique gene (Figure 6B). An identification was considered ambiguous when a peptide sequence was a 100% match without gaps to more than one protein deriving from more than one gene and the identification was based only on that single peptide (Figure 6C). The proteins identified from at least one unambiguous peptide were considered unambiguous proteins. The proteins that contained only ambiguous peptides were considered ambiguous proteins.

Patients with Bartter Syndrome Type I

We collected spot urine samples from two patients with clinically diagnosed Bartter syndrome type I. The patients were enrolled in the institutional review board–approved protocol 76-HG-0238. We obtained written informed consent from the parents and/or patient. We collected urine samples from healthy humans and used them as controls. We processed all samples using the differential centrifugation method to isolate human urinary exosomes described already. Each sample was prepared for immunoblotting by solubilizing in Laemmli buffer (1.5% SDS, 6% glycerol, 10 mM Tris HCl, and 60 mg/ml DTT). The samples, patient 1 and patient 2, and the control samples, control 1 and control 2, were loaded onto a 1-D SDS-PAGE gel on the basis of time as measured by creatinine excretion. The proteins were transferred to Immobilon-P (Millipore) membranes, blocked, and probed with antigen-specific NKCC2 and NCC primary antibodies. We incubated the blots with species-specific fluorescence secondary antibodies (Alexa 688) and visualized them using the Odyssey Infrared Imaging System (LiCor, Lincoln, NE).

Phosphopeptide Enrichment and LC-MS/MS Analysis

We collected urine specimens (200 ml) from six healthy humans, three men and three women. We processed the specimens 400 ml/d for 3 d and pooled them. The exosome isolation was as described previously except that phosphatase inhibitors 10 mM NaF (Sigma, St. Louis, MO), 20 mM β-glycerol phosphate (Fluka, St. Louis, MO), and 1 mM sodium orthovanadate (Sigma) were added. The pellet was resuspended in 6 M guanidine HCl/50 mM NH4HCO3.

The sample was concentrated using a Centricon tube at 13,500 × g, with a starting volume of 420 μl and a final volume of 55 μl. The sample was reduced with 50 mM DTT for 1 h at 56°C. The sample was alkylated by addition of 100 mM iodoacetamide for 1 h (dark) at room temperature and was digested with trypsin overnight at 37°C. The sample was centrifuged at 16,000 × g for 20 min. The supernatant was kept, and 100% FA was added to inactivate the trypsin. The sample was desalted on a 1-ml HLB column (Waters Oasis, Milford, MA) by positive displacement via a syringe with a luer adapter. The sample was eluted with two elution buffers. Elution buffer 1 contained 50% ACN and 0.1% FA, and elution buffer 2 contained 90% ACN and 0.1% FA. The eluents, 50 and 90%, were dried using the SpeedVac.

Phosphopeptides were enriched from the samples using the Pierce Phosphopeptide Isolation Kit (cat. no. 89853) according to the manufacturer's protocol. Phosphopeptide samples were desalted using C18 ZipTips (Millipore) before analysis by mass spectrometry.

Phosphopeptide samples were analyzed on an Agilent 1100 nanoflow system (Agilent Technologies) LC connection to a Finnigan LTQ FT mass spectrometer (Thermo Electron) equipped with a nanoelectrospray ion source as described previously.11 The five most intense ions were sequentially isolated and fragmented (MS2) in the linear ion trap using collision-induced dissociation. The data-dependent neutral loss algorithm in XCALIBUR software was used to trigger an MS3 scan when a neutral loss of 98.0, 49.0, or 32.7 Da was detected among the two most intense fragment ions in a given MS2 spectrum.

Analysis of Phosphopeptide Data Sets

We searched MS raw data files against a composite database containing the forward and reversed peptide sequence of the Human RefSeq Database from January 26, 2007. Putative phosphopeptides were selected and filtered to produce MS2 and MS3 data sets with target FPR of 2% (high stringency) and 20% (low stringency) via the PhosphoPIC program.4 This software was also used to merge MS2 and MS3 data sets into a single file to facilitate subsequent data analysis. Phosphopeptides identified in MS2 spectra were submitted for automated phosphorylation site assignment using the Ascore algorithm.13 A site with an Ascore ≥19 (>99% confidence) was considered to be unambiguously assigned. Phosphopeptides present only in MS3 spectra were checked manually. We used Scansite (http://scansite.mit.edu/motifscan_seq.phtml) to determine the phosphorylation motif for the identified sites. We searched the PhosphoSite database (http://www.phosphosite.org) to determine whether the sites were novel or previously identified.

Urinary Exosome Isolation

Urine was collected from eight healthy humans: Four men (aged 22 to 33) and four women (aged 24 to 35) (National Institute of Diabetes and Digestive and Kidney Diseases Clinical Research Protocol 00-DK-0107). Fifty milliliters per subject was collected and mixed together. The urinary exosome isolation procedure is shown in Figure 4. Protease inhibitors were added (1.67 ml of 100 mM NaN3, 2.5 ml of 11.5 mM 4-[2-aminoethyl] benzenesulfonyl fluoride, and 50 μl of 1 mM leupeptin). The mixed sample was centrifuged at 17,000 × g for 10 min at 4°C. The 17,000 × g supernatant was ultracentrifuged at 200,000 × g for 1 h at 25°C. The ultracentrifugation step was repeated 3 additional times, adding new 17,000 × g supernatant volume each time to each of the 12 tubes. Each of the 12 pellets was suspended with 50 μl of “isolation solution” (10 mM triethanolamine and 250 mM sucrose). The suspensions were pooled together.

An external file that holds a picture, illustration, etc.
Object name is asn0020938610004.jpg

Differential centrifugation procedure for the isolation of urinary exosomes from urine.

The abundant urinary protein uromodulin or Tamm-Horsfall protein forms very high molecular weight complexes through disulfide linkages. These complexes sediment in the 200,000 × g spin unless denatured. To denature the zona pellucida domains in the Tamm-Horsfall protein, we mixed the resuspended pellet with 200 mg/ml dithiothreitol (DTT) at 95°C for 2 min. The resuspended pellet was added to an ultracentrifuge tube, and isolation solution was added to increase the volume to 8 ml. The sample was centrifuged at 200,000 × g for 1 h at 25°C. The pellet was suspended in 50 μl of isolation solution and frozen at −80°C.

In-Gel Trypsin Digestion

The protein concentration was determined using the Bradford Assay. This sample was solubilized in Laemmli sample buffer (1.5% SDS, 6% glycerol/10 mM Tris HCl, and 60 mg/ml DTT). Proteins in the exosome sample were separated by 1D SDS-PAGE using a Bio-Rad Ready Gel 4 to 15% polyacrylamide gradient gel with 125 μg distributed among two lanes. The gel was stained with Colloidal Coomassie Blue (GelCode Blue Stain Reagent; Pierce, Rockford IL) for 10 min and destained using ddH2O (2 × 30 min). The gel was divided from top to bottom into 40 1-mm strips over the entire molecular weight range of the gel. Each strip was diced into small pieces (1 mm) and placed into labeled centrifuge tubes.

The gels pieces were destained by adding 100 μl of 25 mM ammonium bicarbonate (NH4HCO3)/50% acetonitrile (ACN) for 10 min and were dried using a SpeedVac. The samples were reduced in a solution of 10 mM DTT and 25 mM NH4HCO3 at 56°C for 1 h. The samples were alkylated in a solution containing 55 mM iodoacetamide and 25 mM NH4HCO3 in the dark at room temperature for 45 min. The gel pieces were washed with 25 mM NH4HCO3 and dehydrated in a solution containing 25 mM NH4HCO3 and 50% ACN. The samples were dried using the SpeedVac. The samples were rehydrated in a solution containing 12.5 ng/μl trypsin (V5113; Promega, Madison, WI) in 25 mM NH4HCO3 and digested overnight at 37°C. Peptides were extracted using 50% ACN/0.1% formic acid (FA). The extracted samples were dried using the SpeedVac to remove ACN and then reconstituted with 0.1% FA. All 40 peptide samples were desalted using C18 Zip Tips (Millipore, Billerica, MA) before analysis by mass spectrometry.

Nanospray LC-MS/MS

A high-sensitivity linear ion trap mass spectrometer, LTQ (Thermo Electron Corp.) equipped with a nanoelectrospray ion source was used to acquire m/z ratios in both precursor ions (MS1) and fragmented ions (MS2) scans. To reduce further the sample complexity before mass analysis, we injected the tryptic peptides extracted from each gel slice using an Agilent 1100 nanoflow system (Agilent Technologies, Palo Alto, CA) into a reversed-phase liquid chromatographic column (PicoFrit, Biobasic C18; New Objective, Woodburn, MA). This LC-MS/MS method allows the acquisition of raw data files that are the MS/MS scans of the five highest intensity peaks after fragmentation with collision-induced dissociation in the LTQ mass analyzer.

Analysis of Data

The raw data files were searched against the NCBI Reference Sequences (RefSeq) human protein database by using BIOWORKS software (Thermo Finnigan). BIOWORKS utilizes SEQUEST, which is a program that “finds database candidate sequences whose theoretical spectra are compared with the experimental spectrum.”27 To identify thoroughly peptide sequences, we searched the raw data files using the target-decoy approach and InsPecT.

In addition, we analyzed the data in a two-step process. The first step was to assess and minimize false-discovery peptide identifications using the target-decoy approach, manual inspection of spectra, and InsPecT. The second step was to assess and eliminate ambiguous protein identifications.

Target-Decoy

To apply the target-decoy database searching strategy,13 we used the NHLBI Proteomics Core Facility in-house software to create a composite database containing the forward and reverse sequences of the nonredundant NCBI Reference Sequences (RefSeq) human protein database released on January 26, 2007. We used the forward sequences as the target database and the reversed sequences as the decoy database. We searched the raw data files against this composite database. After the search, we assessed the FDR by the number of peptides matched from the reversed sequences. The parameters that determine the stringency of the filtering criteria include XCorr, Sp rank, and delta Cn. These parameters were incrementally adjusted, thereby reducing the false-discovery identifications until a target FDR was achieved. In our case, the data were filtered to a target of 2% FDR, and the actual FDR was 1.91%. The filter settings used were min Xcorr rank 1, min Sp rank 10, min delta Cn 0.08, charge + 1 min Xcorr 2.37, charge + 2 min Xcorr 2.87, and charge + 3 min Xcorr 3.37.

InsPecT

We performed an additional analysis of the tandem mass spectrometry data using the InsPecT tool.28 InsPecT uses de novo sequencing to generate sequence information (tag filters) from the experimental data. The tag filters are used to search the human protein database, nonredundant NCBI Reference Sequences (RefSeq) human protein database released on January 26, 2007, and identify peptide sequences that match with the experimental data. The size of the tag filters are three peptides in length on average. As shown in Figure 5, the tag filter generated for the protein CHMP1A matches the experimental data accurately. The peptide sequences identified using the tag filters are then scored to estimate that the top match is correct.28 The score procedure computes the P value for each peptide sequence by “comparing the match quality score to the distribution of quality scores for incorrect matches.” For these data, we accept only peptide matches with P ≤ 0.05.

An external file that holds a picture, illustration, etc.
Object name is asn0020938610005.jpg

Spectrum generated by InsPecT for CHMP1A protein (NP_002759). The peptide sequence is RVYAENAIRK. The tag region for the b ions and the y ions are shown by the black solid lines.

Minimizing False-Discovery Peptide Identifications

In addition to the target-decoy approach the InsPecT analysis, we validated the quality of proteins identified by manually checking the spectra of those proteins with one unique peptide. We filtered out the proteins that did not have the expected molecular weight that matched to the corresponding regions in the 1-D SDS PAGE.

Elimination of Ambiguous Protein Identifications

Once proteins were identified using the approaches described, we needed to determine whether all identifications corresponded to unique gene products. An “ambiguous identification” is defined as an identification for which the peptide sequence that is used to determine the protein identity is found in multiple proteins that are not splice variants of the same gene (Figure 6).

An external file that holds a picture, illustration, etc.
Object name is asn0020938610006.jpg

Criteria to disambiguate data set. (A) An unambiguous identification when a peptide sequence was a 100% match without gaps to one and only one protein. (B) An unambiguous identification when a peptide sequence was a 100% match without gaps to more than one protein, but these proteins are splice-variant products of one unique gene. (C) An ambiguous identification when a peptide sequence was a 100% match without gaps to more than one protein deriving from more than one gene, and the identification was based only on that single peptide.

To disambiguate the data set, we generated software that automates the comparison of each peptide sequence to the protein sequences in the RefSeq Human Protein Database using the BLAST algorithm. An identification was considered unambiguous when the sequence was a 100% match without gaps to one and only one protein (Figure 6A). An identification was also considered unambiguous when the sequence was a 100% match without gaps to more than one protein but these proteins are splice-variant products of one unique gene (Figure 6B). An identification was considered ambiguous when a peptide sequence was a 100% match without gaps to more than one protein deriving from more than one gene and the identification was based only on that single peptide (Figure 6C). The proteins identified from at least one unambiguous peptide were considered unambiguous proteins. The proteins that contained only ambiguous peptides were considered ambiguous proteins.

Patients with Bartter Syndrome Type I

We collected spot urine samples from two patients with clinically diagnosed Bartter syndrome type I. The patients were enrolled in the institutional review board–approved protocol 76-HG-0238. We obtained written informed consent from the parents and/or patient. We collected urine samples from healthy humans and used them as controls. We processed all samples using the differential centrifugation method to isolate human urinary exosomes described already. Each sample was prepared for immunoblotting by solubilizing in Laemmli buffer (1.5% SDS, 6% glycerol, 10 mM Tris HCl, and 60 mg/ml DTT). The samples, patient 1 and patient 2, and the control samples, control 1 and control 2, were loaded onto a 1-D SDS-PAGE gel on the basis of time as measured by creatinine excretion. The proteins were transferred to Immobilon-P (Millipore) membranes, blocked, and probed with antigen-specific NKCC2 and NCC primary antibodies. We incubated the blots with species-specific fluorescence secondary antibodies (Alexa 688) and visualized them using the Odyssey Infrared Imaging System (LiCor, Lincoln, NE).

Phosphopeptide Enrichment and LC-MS/MS Analysis

We collected urine specimens (200 ml) from six healthy humans, three men and three women. We processed the specimens 400 ml/d for 3 d and pooled them. The exosome isolation was as described previously except that phosphatase inhibitors 10 mM NaF (Sigma, St. Louis, MO), 20 mM β-glycerol phosphate (Fluka, St. Louis, MO), and 1 mM sodium orthovanadate (Sigma) were added. The pellet was resuspended in 6 M guanidine HCl/50 mM NH4HCO3.

The sample was concentrated using a Centricon tube at 13,500 × g, with a starting volume of 420 μl and a final volume of 55 μl. The sample was reduced with 50 mM DTT for 1 h at 56°C. The sample was alkylated by addition of 100 mM iodoacetamide for 1 h (dark) at room temperature and was digested with trypsin overnight at 37°C. The sample was centrifuged at 16,000 × g for 20 min. The supernatant was kept, and 100% FA was added to inactivate the trypsin. The sample was desalted on a 1-ml HLB column (Waters Oasis, Milford, MA) by positive displacement via a syringe with a luer adapter. The sample was eluted with two elution buffers. Elution buffer 1 contained 50% ACN and 0.1% FA, and elution buffer 2 contained 90% ACN and 0.1% FA. The eluents, 50 and 90%, were dried using the SpeedVac.

Phosphopeptides were enriched from the samples using the Pierce Phosphopeptide Isolation Kit (cat. no. 89853) according to the manufacturer's protocol. Phosphopeptide samples were desalted using C18 ZipTips (Millipore) before analysis by mass spectrometry.

Phosphopeptide samples were analyzed on an Agilent 1100 nanoflow system (Agilent Technologies) LC connection to a Finnigan LTQ FT mass spectrometer (Thermo Electron) equipped with a nanoelectrospray ion source as described previously.11 The five most intense ions were sequentially isolated and fragmented (MS2) in the linear ion trap using collision-induced dissociation. The data-dependent neutral loss algorithm in XCALIBUR software was used to trigger an MS3 scan when a neutral loss of 98.0, 49.0, or 32.7 Da was detected among the two most intense fragment ions in a given MS2 spectrum.

Analysis of Phosphopeptide Data Sets

We searched MS raw data files against a composite database containing the forward and reversed peptide sequence of the Human RefSeq Database from January 26, 2007. Putative phosphopeptides were selected and filtered to produce MS2 and MS3 data sets with target FPR of 2% (high stringency) and 20% (low stringency) via the PhosphoPIC program.4 This software was also used to merge MS2 and MS3 data sets into a single file to facilitate subsequent data analysis. Phosphopeptides identified in MS2 spectra were submitted for automated phosphorylation site assignment using the Ascore algorithm.13 A site with an Ascore ≥19 (>99% confidence) was considered to be unambiguously assigned. Phosphopeptides present only in MS3 spectra were checked manually. We used Scansite (http://scansite.mit.edu/motifscan_seq.phtml) to determine the phosphorylation motif for the identified sites. We searched the PhosphoSite database (http://www.phosphosite.org) to determine whether the sites were novel or previously identified.

Disclosures

None.

Laboratory of Kidney and Electrolyte Metabolism, National Heart, Lung, and Blood Institute, Renal Diagnostics and Therapeutics Unit, National Institute of Diabetes and Digestive and Kidney Diseases, Section of Human Biochemical Genetics, Medical Genetics Branch, National Human Genome Research Institute, and Office of Rare Diseases, Office of the Director, National Institutes of Health, Bethesda, and Department of Chemical and Biomolecular Engineering, University of Maryland, College Park, Maryland; and London Epithelial Group, Centre for Nephrology, University College London, London, United Kingdom
Correspondence: Dr. Mark A. Knepper, 10 Center Drive, MSC-1603, National Institutes of Health, Bethesda, MD 20892-1603. Phone: 301-496-3064; Fax: 301-402-1443; E-mail: vog.hin.xileh@penk
Correspondence: Dr. Mark A. Knepper, 10 Center Drive, MSC-1603, National Institutes of Health, Bethesda, MD 20892-1603. Phone: 301-496-3064; Fax: 301-402-1443; E-mail: vog.hin.xileh@penk
Received 2008 Apr 21; Accepted 2008 Jul 30.

Abstract

Normal human urine contains large numbers of exosomes, which are 40- to 100-nm vesicles that originate as the internal vesicles in multivesicular bodies from every renal epithelial cell type facing the urinary space. Here, we used LC-MS/MS to profile the proteome of human urinary exosomes. Overall, the analysis identified 1132 proteins unambiguously, including 177 that are represented on the Online Mendelian Inheritance in Man database of disease-related genes, suggesting that exosome analysis is a potential approach to discover urinary biomarkers. We extended the proteomic analysis to phosphoproteomic profiling using neutral loss scanning, and this yielded multiple novel phosphorylation sites, including serine-811 in the thiazide-sensitive Na-Cl co-transporter, NCC. To demonstrate the potential use of exosome analysis to identify a genetic renal disease, we carried out immunoblotting of exosomes from urine samples of patients with a clinical diagnosis of Bartter syndrome type I, showing an absence of the sodium-potassium-chloride co-transporter 2, NKCC2. The proteomic data are publicly accessible at http://dir.nhlbi.nih.gov/papers/lkem/exosome/.

Abstract

Urinary exosomes are small extracellular vesicles (<100 nm in diameter) that originate from the internal vesicles of multivesicular bodies (MVB) in renal epithelial cells, including glomerular podocytes, renal tubule cells, and the cells lining the urinary drainage system.1 Exosomes are released into the urine when the outer membrane of the MVB fuses with the apical plasma membrane of the epithelial cell.

Exosomes can be recovered from the urine by differential centrifugation as a low-density membrane fraction. Exosome isolation can result in marked enrichment of low-abundance urinary proteins that have potential pathophysiologic significance. As a consequence, we and others have been working to define optimal conditions for their isolation and purification as a prelude to their use in biomarker discovery studies.13

In this study, we thoroughly expanded the known proteome of human urinary exosomes by using a highly sensitive LC-MS/MS system, improved software for identification of peptide ions and a more elaborate data analysis strategy than in our previous study. In addition, we used a neutral loss scanning approach4 to investigate the phosphoproteome of human urinary exosomes. The study identified 1412 proteins including 14 phosphoproteins in human urinary exosomes. Overall, there are 177 proteins that are associated with diseases as judged by their presence on the Online Mendelian Inheritance in Man (OMIM) database, 34 of which are known to be associated with renal diseases. The potential clinical usefulness of urinary exosomes was demonstrated using the well-defined renal tubulopathy, Bartter syndrome type I, as an example. The rich information from the proteomic analysis also provides further insight into the biogenesis of urinary exosomes.

Acknowledgments

We thank Brian Ruttenberg for valuable contribution in developing the code/program used to disambiguate the proteomic data.

Acknowledgments

Notes

Published online ahead of print. Publication date available at www.jasn.org.

Supplemental information for this article is available online at http://www.jasn.org/.

Notes
Published online ahead of print. Publication date available at www.jasn.org.Supplemental information for this article is available online at http://www.jasn.org/.

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