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This protocol describes a method for the isolation of urinary extracellular vesicles, uEVs, from healthy human donors and their phenotypic characterization by the size and surface marker expression using flow cytometry.
Extracellular vesicles, EVs, are a heterogeneous complex of lipidic membranes, secreted by any cell type, in any fluid such as urine. EVs can be of different sizes ranging from 40-100 nm in diameter such as in exosomes to 100-1000 nm in microvesicles. They can also contain different molecules that can be used as biomarkers for the prognosis and diagnosis of many diseases. Many techniques have been developed to characterize these vesicles. One of these is flow cytometry. However, there are no existing reports to show how to quantify the concentration of EVs and differentiate them by size, along with biomarker detection. This work aims to describe a procedure for the isolation, quantification, and phenotypification of urinary extracellular vesicles, uEVs, using a conventional cytometer for the analysis without any modification to its configuration. The method's limitations include staining a maximum of four different biomarkers per sample. The method is also limited by the amount of EVs available in the sample. Despite these limitations, with this protocol and its subsequent analysis, we can obtain more information on the enrichment of EVs markers and the abundance of these vesicles present in urine samples, in diseases involving kidney and brain damage.
In mammals, blood is filtered by passing through the kidneys 250 - 300 times; during this time, urine is formed. Production of this biofluid is the result of a series of processes, including glomerular filtration, tubular reabsorption, and secretion. Metabolic waste products and electrolytes are the main components of urine. Also, other byproducts such as peptides, functional proteins, and extracellular vesicles (EVs) are excreted1,2,3,4,5,6. Initially, urinary extracellular vesicles (uEVs) were identified in urine samples from patients suffering from water-balance disorders. These patients showed the presence of molecules such as aquaporin-2 (AQP2), which was then used as a biomarker for this disease7. Several subsequent studies focused on identifying the cellular origin of uEVs, describing that these structures can be secreted by kidney cells (glomerulus, podocytes, etc.) and other cell types of endothelial or leukocytic lineages. Moreover, the number and molecule-enrichment in uEVs can correlate with the status of many diseases and disorders8,9,10,11,12,13,14.
Altogether, EVs make up a highly heterogeneous family of particles enclosed by lipid bilayers and released by cells through passive or active mechanisms into different fluids. Depending on their origin, EVs can be classified as endosome originated exosomes or plasma membrane-derived microvesicles/microparticles. However, this classification criterion can only be applied when the biogenesis of the particles is directly observed. Therefore, other non-trivial criteria, including physical, biochemical, and cellular origin, have been endorsed by several researchers in the field15,16,17. Depending on the nature of the isolate analyzed, different analytical techniques were suggested for EVs characterization. For example, based on the enrichment of big (≥100 nm) or small (≤100 nm) EVs, quantification via flow cytometry or nanoparticle tracking is suggested, respectively18.
Nowadays, the use of EVs as biomarkers for many diseases has become relevant, so the search for different sources are been investigated. One of the most promising sources is the urine as it can be obtained in an easy and non-invasive manner. Therefore, this protocol describes a procedure for the isolation of uEVs by differential centrifugation, processing with fluorochrome-conjugated antibodies, and downstream analysis using a conventional 2-lasers/4-colors cytometer.
The human urine samples were obtained from healthy volunteers who had signed donor-informed consent. These procedures were also approved by the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Research Ethics Committee.
1. Isolation of urinary extracellular vesicles
NOTE: The isolation protocol of uEVs is modified from ref.19. Figure 1 depicts the representation of the protocol to isolate uEVs.
Figure 1: Overview of the uEVs isolation for flow cytometry analysis. In this protocol, first centrifuge the first urine of the day to remove the cells and debris. Then centrifuge to remove the large vesicles with treatment to remove the THP protein and finally perform ultracentrifugation to enrich and obtain the uEVs with a single wash. Steps to keep urine fractions for the WB validation are marked. Please click here to view a larger version of this figure.
2. Staining of uEVs
NOTE: Before staining and analysis of uEVs, it is essential to perform at least one methodology recommended by MISEV201818 to verify proper isolation of uEVs; here, Western blot analysis is depicted. Figure 2 shows a representative protocol to uEVs stain.
Figure 2: Overview of the uEVs staining and capture in the cytometer. (A) Representation of the uEV staining. For 500,000 uEVs, the antibody was mixed and incubated at 4 °C for 12 h. Then CFSE was added and incubated at 37 °C for 10 min. The uEVs had the CFSE inside, and the antibody will bind to the surface of the antigen. 400 µL of cold PBS was used to resuspend and to capture 100 µL of the sample in the flow cytometer at a slow velocity. (B) Analysis strategy. The first dot plot (SSC-H VS FL-X) depicts the negative control for uEVs, followed by the dot plot showing uEVs staining with CFSE, and finally, a histogram with the antibody staining of uEVs (black line), the negative control is shown in the grayline. Please click here to view a larger version of this figure.
Tube 1. | Megamix FSC beads | |
Tube 2. | PBS | |
Tube 3. | PBS with CFSE | |
Tube 4. | PBS with all antibodies of problem 1 | |
Tube 5. | PBS with all antibodies of problem 2 | |
Tube 6. | Autofluorescence control | uEVs without any reagent, only in PBS. |
Tube 7. | #uEVs | uEVs with CFSE |
Tube 8. | Problem 1 | uEVs with CD37 FITC, CD53 PE, ADAM10 APC |
Tube 9. | Problem 2 | uEVs with CD9 FITC, TSPAN33 APC |
Table 1: Tubes labeling. Example showing how to label the tubes. The first tubes are all the controls needed. The tubes with the antibodies-fluorochromes will depend on the staining.
3. Acquisition of uEVs using a conventional cytometer
NOTE: Instructions for the use of the flow cytometer (see Table of Materials) are described here.
Figure 3: Megamix FSC beads dot plots. The dot plots showed were generated using the flow cytometer software; in the flow cytometer, the image will be very similar. (A) The first dot plot generated to select the beads avoiding the background noise. (SSC-H VS FL1-H). (B) The dot plot generated by the selection of the previous gate, showing the different sizes of the beads. (SSC-H VS FSC-H). Please click here to view a larger version of this figure.
4. Analysis of the data with a flow cytometer software.
NOTE: Instructions for using the flow cytometer software depicted in the table of materials, are described in this section. Figure 4 shows the workspace with the steps to create the size gates.
Figure 4: Workspace with all the steps to begin the analysis of the data. All the images were generated by screen printing of the workspace. (A) Workspace generated with the sample data added (left), dot plot generated by the selection of the tube 1, FSC beads, (right). (B,C) show the modification of the axis, to have SSC-H and FSC-H. (D-F) show step-by-step customization of both axes. (G-I) show the selection and generation of the different bead sizes. Please click here to view a larger version of this figure.
Figure 5: Workspace to analyze the data obtained. All the images were generated by the screen printing of the workspace. (A) Workspace generated with the size gate applied to all the samples. (B) Autofluorescence tube selected, dot plot showing the size gate, and the histogram for one selected size (0.1 µm), use this histogram to obtain the positive gate for each fluorochrome and size. (C) Workspace generated with the positive gates for each fluorochrome and size. (D) Workspace (left) and Layout Editor (right) generated for the samples. In the Layout Editor is shown the histogram for autofluorescence tube and positive tube for FL1-H, and how to obtain the properties panel to modify them. (E) The image shows how to obtain the mean intensity fluorescence value. (F) Histograms generated for three different fluorochromes, showing all the changes that the software allows to do with the statistic information. Please click here to view a larger version of this figure.
5. Analysis to obtain the number of uEVs per sample.
NOTE: Figure 6 shows the workspace with the steps to obtain the number of uEVs per sample.
Figure 6: Workspace to analyze the CFSE tube. All the images were generated by screen printing of the workspace. (A) Workspace generated by the selection of all the sizes region, uEVs total (left), dot plot showing the gate selected (right). (B) Dot plot SSC-H VS FL1-H for CFSE negative region in the autofluorescence tube. (C) Dot plot SSC-H VS FL1-H for CFSE in the staining tube. (D) Image of the table obtained with the statistics of the CFSE staining, showing the number of uEVs in the sample. Please click here to view a larger version of this figure.
There are several checkpoints through the protocol, and before the staining of uEVs. Therefore, it is essential to first verify the amount of protein present in the extract of uEVs. All the research groups that work with extracellular vesicles quantify the protein, as indicated in step 2.1. Supplementary Figure 2 shows a representative 96 well plate containing uEVs fraction in wells 4E, 5E, and 6E. Wells 1A, 2A, and 3A consist of blanks, but if there are no uEVs purified, the wells will take similar colo...
Nowadays, the use of extracellular vesicles as biomarkers for several diseases has augmented, especially for those that can be isolated from non-invasive sources such as urine5,21,22,23,24. It has been proved that the isolation of uEVs is a vital resource to know the status of a healthy individual, and the diagnosis/prognosis of patients suffering several dise...
The authors declare that the research was conducted in the absence of any financial or commercial relationship that could be construed as a potential conflict of interest.
This work was supported by grants from CONACyT (A3-S-36875) and UNAM-DGAPA-PAPIIT Program (IN213020 and IA202318). NH-I was supported by fellowship 587790 from CONACyT.
The authors want to thank Leopoldo Flores-Romo†, Vianney Ortiz-Navarrete, Antony Boucard Jr and Diana Gómez-Martin for their valuable advice for the realization of this protocol, and to all the healthy individuals for their urine samples.
Name | Company | Catalog Number | Comments |
APC anti human CD156c (ADAM10) antibody | BioLegend | 352706 | Add 5 µL to the 20 µL of uEVs in PBS |
APC anti human TSPAN33 (BAAM) antibody | BioLegend | 395406 | Add 5 µL to the 20 µL of uEVs in PBS |
Avanti centrifuge with JA-25.5O fixed angle rotor | Beckamn Coulter | J-26S XPI | |
BD Accuri C6 Flow Cytometer | BD Biosciences | ||
β-mercaptoethanol | SIGMA-Aldrich | M3148 | |
Benchtop centrifuge with A-4-44 rotor | Eppendorf | 5804 | |
BLUEstain 2 protein ladder | GOLDBIO | P008 | |
CD9 (C-4) mouse monoclonal antibody | Santa Cruz Biotechnology | sc-13118 | |
CD63 (MX-49.129.5) mouse monoclonal antibody | Santa Cruz Biotechnology | sc-5275 | |
Cell Trace CFSE cell proliferation kit for flow cytometry | Thermo Scientific | C34554 | |
Chemidoc XRS+ system | BIORAD | 5837 | |
FITC anti human CD9 antibody | BioLegend | 312104 | Add 5 µL to the 20 µL of uEVs in PBS |
FITC anti human CD37 antibody | BioLegend | 356304 | Add 5 µL to the 20 µL of uEVs in PBS |
Fluorescent yellow particles | Spherotech | FP-0252-2 | |
Fluorescent yellow particles | Spherotech | FP-0552-2 | |
Fluorescent yellow particles | Spherotech | FP-1552-2 | |
FlowJo Software | Becton, Dickinson and Company | ||
Goat anti-mouse immunoglobulins/HRP | Dako | P0447 | |
Halt protease inhibitor cocktail | Thermo Scientific | 78429 | |
Immun-Blot PVDF membrane 0.22µm | BIORAD | 1620177 | |
Megamix-Plus FSC beads | COSMO BIO CO.LTD | 7802 | |
NuPAGE LDS sample buffer 4X | Thermo Scientific | NP0007 | |
Optima ultracentrifuge with rotor 90Ti fixed angle 355530 | Beckamn Coulter | XPN100 | |
Page Blue protein staining solution | Thermo Scientific | 24620 | |
PE anti human CD53 antibody | BioLegend | 325406 | Add 5 µL to the 20 µL of uEVs in PBS |
Pierce BCA Protein assay kit | Thermo Scientific | 23227 | |
Pierce RIPA buffer | Thermo Scientific | 89900 | |
Polycarbonate thick wall centrifuge tubes | Beckamn Coulter | 355630 | |
Spherotech 8-Peak validation beads (FL1-FL3) | BD Accuri | 653144 | |
Spherotech 6-Peak validation beads (FL4) | BD Accuri | 653145 | |
Sucrose | SIGMA-Aldrich | 59378 | |
Triethanolamine | SIGMA-Aldrich | 90279 |
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