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Urinary exosomal vitronectin as a biomarker in predicting vesicoureteral reflux in neurogenic bladder patients with spinal cord injury
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  • Jue Li,
  • Chunxian Zeng,
  • Ling Chen,
  • Chun Zhao,
  • Ying Huang,
  • wenzhi Cai
Jue Li
Shenzhen Hospital of Southern Medical University
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Chunxian Zeng
Shenzhen Hospital of Southern Medical University
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Ling Chen
Shenzhen Hospital of Southern Medical University
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Chun Zhao
Shenzhen Hospital of Southern Medical University
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Ying Huang
Shenzhen Hospital of Southern Medical University
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wenzhi Cai
Shenzhen Hospital of Southern Medical University

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Abstract

Objective: Neurogenic bladder is an important complication of urinary tract dysfunction after spinal cord injury. Urodynamic and urography to guide therapy remains invasive and complicated. Therefore, this research is to find potential non-invasive biomarkers from urinary exosomes to predict diagnosis and guide prognosis in patients with spinal cord injury. Methods: Urinary exosomes were isolated and proteome profile was analyzed by mass spectrometry. Transmission electron microscopy and nanoparticle tracking analysis confirmed the size and morphology characteristic of urinary exosomes. In addition, bioinformatics analysis and parallel reaction monitoring were used for screening candidate biomarkers. Selected biomarkers were validated by Western blot and ELISA. Results: Mass spectrometry identified 134 up-regulated proteins and 99 down-regulated proteins between VUR and non-VUR groups. 18 candidate proteins were selected for PRM validation, but only VTN and COL1A1 showed significant differences. In the validation experiment by western blot and ELISA, VTN was exclusively highly expressed in VUR patients compared with non-VUR patients. However, the ELISA result of COL1A1 showed no statistical difference in a bigger sample size. Furthermore, a receiver operating characteristic curve of ELISA-based VTN showed an area under the curve of 0.795, and 80% sensitivity at a threshold set to give 82.9% specificity. Conclusions: Collectively, our results suggest that VTN in urinary exosomes may be used as a biomarker to predict the progression and guide the prognosis of neurogenic bladder disease.