The exosomal protein biomarkers auxiliary in diagnosis of interstitial lung disease

Abstract Background Exosome liquid biopsies might be a good supplement for early diagnosis of interstitial lung disease (ILD), especially those challenging cases such as connective tissue disease-ILD (CTD-ILD). Methods We developed a circulating exosomal proteomic signature to identify novel biomark...

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Main Authors: Ming Dong, Gaolei Hu, Xi Chen, Lingling Zhang, Yuxiao Zhang, Yanting Fang, Shuilin Liao, Yukai Wang, Qian Li, Peiyan Zheng, Bingpeng Guo, Tinpou Lai, Qun Luo, Huimin Huang, Qian Han, Baoqing Sun
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Respiratory Research
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Online Access:https://doi.org/10.1186/s12931-025-03326-2
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Summary:Abstract Background Exosome liquid biopsies might be a good supplement for early diagnosis of interstitial lung disease (ILD), especially those challenging cases such as connective tissue disease-ILD (CTD-ILD). Methods We developed a circulating exosomal proteomic signature to identify novel biomarkers of ILDs combined with high-resolution CT (HRCT) examination and a new method that makes exosome testing clinically feasible. Blood-derived exosomes were extracted and characterized using a centrifugal microfluidic disc system (Exo-CMDS)-based chemiluminescence immunoassay before being subjected to proteomic analysis by mass spectrometry. Significantly differentially expressed proteins (DEPs) were identified and validated in > 600 clinical samples (collected at three hospitals) by comparing the ILD and disease/healthy control groups. Multivariable logistic regression (LR) analysis was implemented to test the diagnostic performance of the selected biomarkers either alone or in combination. Results Candidate biomarkers KL-6, CAPN2, SP-B were selected from the top DEPs. An LR model that combined exosomal KL-6/CAPN2/SP-B levels performed well in both the discovery (AUC = 0.987, 95%CI = 0.975–0.998) and validation (AUC = 0.936, 95%CI = 0.911–0.960) sets. The LR model based on the three biomarkers exhibited markedly better diagnostic performance (AUC = 0.880, 95%CI = 0.834–0.925) in serum-KL-6-negative ILD, than the conventional serum-KL-6-based method and could also accurately diagnose connective tissue disease associated-ILD (CTD-ILD) in the context of CTD. Conclusion The circulating exosomal protein detection system used in this study represents a valuable tool for identifying promising exosomal biomarkers for ILD and holds promise for improving the diagnosis and prognosis of patients with ILD in the future.
ISSN:1465-993X