Quantitative proteomics and phosphoproteomics of urinary extracellular vesicles define putative diagnostic biosignatures for Parkinson's disease

Commun Med (Lond). 2023 May 10;3(1):64. doi: 10.1038/s43856-023-00294-w.

Abstract

Background: Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene have been recognized as genetic risk factors for Parkinson's disease (PD). However, compared to cancer, fewer genetic mutations contribute to the cause of PD, propelling the search for protein biomarkers for early detection of the disease.

Methods: Utilizing 138 urine samples from four groups, healthy individuals (control), healthy individuals with G2019S mutation in the LRRK2 gene (non-manifesting carrier/NMC), PD individuals without G2019S mutation (idiopathic PD/iPD), and PD individuals with G2019S mutation (LRRK2 PD), we applied a proteomics strategy to determine potential diagnostic biomarkers for PD from urinary extracellular vesicles (EVs).

Results: After efficient isolation of urinary EVs through chemical affinity followed by mass spectrometric analyses of EV peptides and enriched phosphopeptides, we identify and quantify 4476 unique proteins and 2680 unique phosphoproteins. We detect multiple proteins and phosphoproteins elevated in PD EVs that are known to be involved in important PD pathways, in particular the autophagy pathway, as well as neuronal cell death, neuroinflammation, and formation of amyloid fibrils. We establish a panel of proteins and phosphoproteins as novel candidates for disease biomarkers and substantiate the biomarkers using machine learning, ROC, clinical correlation, and in-depth network analysis. Several putative disease biomarkers are further partially validated in patients with PD using parallel reaction monitoring (PRM) and immunoassay for targeted quantitation.

Conclusions: These findings demonstrate a general strategy of utilizing biofluid EV proteome/phosphoproteome as an outstanding and non-invasive source for a wide range of disease exploration.

Plain language summary

Parkinson’s disease (PD) is a progressive neurological disorder that affects body movement because some brain cells stop producing the chemical dopamine. PD is often not diagnosed until it has advanced, making early detection crucial. To enable early detection, we investigated tiny packages called extracellular vesicles released from a variety of cells, including the brain cells, that can be found in urine as a potential source for diagnosing PD. These tiny packages contain different kinds of molecules from inside the cells. We analyzed urine samples from 138 individuals and found several proteins involved in PD development that could be biological indicators for early detection of the disease. We used various techniques to make sure that our findings were accurate. Our study suggests that looking at these proteins in urine could be a good way to detect PD in a non-invasive manner.