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Archives of Medical Science : AMS logoLink to Archives of Medical Science : AMS
. 2019 Apr 30;15(3):738–753. doi: 10.5114/aoms.2019.84690

Differential expression study of circular RNAs in exosomes from serum and urine in patients with idiopathic membranous nephropathy

Hualin Ma 1, Ying Xu 2, Rongrong Zhang 1, Baochun Guo 1, Shuyan Zhang 1, Xinzhou Zhang 1,
PMCID: PMC6524185  PMID: 31110542

Abstract

Introduction

The aim of the study was to further explore the pathogenesis of idiopathic membranous nephropathy (IMN), gene-sequencing was used to analyze the differentially expressed circRNAs in exosomes of patients with IMN, which may lay the foundation for the research of circRNAs as a new class of exosome-based IMN diagnosis biomarkers.

Material and methods

Ten patients with IMN and ten normal controls were recruited as experimental subjects in our study. The exosomes were extracted from the collected serum and urine. Then, pure circRNAs were extracted from the exosomes with a series of enzymatic reactions. Afterwards, the significantly differentially expressed circRNAs were chosen by the method of gene-sequencing.

Results

Compared with normal controls, the circRNAs were reduced in the exosomes from serum of patients with IMN, which mostly originated from intron gene regions. Meanwhile, a total of 89 circRNAs were significantly differentially expressed, which were also mostly derived from intron gene regions, including 49 up-regulated and 40 down-regulated genes. However, the species were increased in the exosomes from the urine of patients with IMN compared to normal controls, and they mainly originated from exon gene regions. Simultaneously, 60 circRNAs were significantly differentially expressed, which primarily belonged to intron gene regions, including 54 up-regulated and 6 down-regulated regions.

Conclusions

The significant differential and specific expression of circRNAs in the exosomes from patients with IMN were observed. For example, MUC3A, which originated from chr7:100550808|100551062, could be considered a potential diagnostic biomarker of IMN. Furthermore, these figures may be used as a reference or supplement in the research of the pathogenesis of IMN.

Keywords: exosome, circular RNA, idiopathic membranous nephropathy, gene sequencing

Introduction

Idiopathic membranous nephropathy (IMN) is the most common cause of adult nephrotic syndrome. Approximately 25% to 40% of adult primary nephrotic syndrome cases have IMN. Idiopathic membranous nephropathy is also the most common pathologic type of glomerular disease, and IMN has a longer disease course. The prognosis of IMN varies [1]. The pathologic features of IMN are a high number of immune complexes deposited in the glomerular basement membrane on the epithelium side.

The exosome has a double layer plasma membrane structure. Its diameter is approximately 30–100 nm, and it carries a rich protein, mRNA and microRNA. Exosomes are released to the extracellular microenvironment by the cells [2, 3]. They can be released from fibroblasts, dendritic cells, tumor cells and other cells; they are widespread in the urine [4], peripheral blood, saliva, cerebrospinal fluid, amniotic fluid, ascites and other body fluids [3, 5]. Therefore, we can detect exosomes and their contents from tissue, cells and body fluids to diagnose and clinically treat the disease, especially kidney disease. Miranda et al. [6] observed exosomes of renal tubular epithelial cells, podocytes, collecting duct cells and leap cells by transmission electron microscopy, which showed that almost all kidney inherent cells could secrete exosomes. In addition, the authors found that the components of exosomes were different in normal physiological conditions and disease conditions even for the same tissue or body fluid [7]. Previous studies have shown that the contents of exosomes have a characteristic change in acute kidney injury [8], IgA nephropathy [9], diabetic nephropathy [10], renal tubular acidosis [6], polycystic kidney [11] and other kidney diseases. The findings suggested that exosomes can be used as specific markers for early disease diagnosis.

Recent studies have shown that circRNAs can be used as biomarkers for the diagnosis and efficacy of a variety of clinical diseases, such as atherosclerosis [12], neurological diseases [1315], diabetes [16], tumors [1719] and more. In addition, because of the high stability of the circRNAs and the difficulty of degrading them by exonuclease, we can easily obtain circRNA from body fluid [12]. Based on the above characteristics, circRNAs show great potential to regulate human disease genes [20], making them a current research focus. In 2005, Huang found many exosomes in human serum and discovered that there is a difference in the exo-circRNA between colorectal cancer and normal human serum [21]. The authors speculated that circRNAs could be used as a new biomarker for cancer diagnosis. This discovery renewed people’s awareness of circRNAs and exosomes because the authors had linked two emerging areas and further demonstrated the importance of circRNA and exosomes in organisms [21].

In this study, we evaluated circRNAs of exosomes. We compared the expression of circRNAs in the exosomes of serum and urine in patients with idiopathic membranous nephropathy and normal healthy controls by gene sequencing. Then, we screened out the differential expression of circRNAs and performed further analysis. The rich data from the analysis provide insight into the pathogenesis of IMN and a solution for future diagnosis and treatment.

Material and methods

Patient assessments and classifications

The study protocols and consent forms were approved by the Second Clinical Medical College (Shenzhen People’s Hospital) of Jinan University and adhere to the Helsinki Declaration guidelines on ethical principles for medical research involving human subjects. Written informed consent was obtained from all participants. Ten IMN patients who had never been treated with glucocorticoids or other immunosuppressive drugs were recruited for this study. In addition, we chose 10 healthy subjects as controls (Table I).

Table I.

Clinical characteristics of IMN patients and normal controls

Group IMN group NC group
Age [years] 38.61 ±11.21 35.14 ±12.13
Sex (M/F) 7/3 7/3
Serum creatinine [µmol/l] 74.9 ±23.6 63.8 ±20.4
Proteinuria [g/24 h] 2.50 ±1.28 0.08 ±0.03
Serum albumin [g/l] 34.04 ±8.79 42.57 ±3.16
PLA2R (%) 60% (6/10) 0% (0/10)

NC group – normal control group.

Inclusion and exclusion criteria

The inclusion criteria were as follows: IMN patients were hospitalized at Shenzhen People’s Hospital nephrology department from November 2015 to October 2016. Renal biopsy confirmed that their pathological type was idiopathic membranous nephropathy and their kidney function was normal before and after admission.

The exclusion criteria were as follows: 1) patients with abnormal renal function based on increased urea nitrogen or creatinine; 2) secondary nephrotic syndrome patients, such as those with hypertensive nephropathy, diabetic nephropathy, lupus nephritis, and hepatitis-related nephritis; and 3) renal pathology results confirming membranous nephropathy, but the patient has co-occurrence of another disease that can cause renal damage, such as hypertension, diabetes, systemic lupus erythematosus, hepatitis B and others.

Collection of serum and urine specimens:

  1. All patients met the inclusion criteria and they were prohibited from eating or drinking the night before specimens were collected.

  2. Venous blood was collected the next morning from elbow vein blood and then kept at 37°C to promote coagulation.

  3. Samples were centrifuged for approximately 10 min at 3000 rpm.

  4. Approximately 2–3 ml of the upper layer of liquid was absorbed into the EP tube, which was marked with identification information (date, number, etc.) and then stored at –80°C.

  5. At the same time, the patient’s first morning urine (approximately 100 ml) was collected into a centrifuge tube, which was marked with identifying information (date, number, etc.) and then stored at –80°C.

Exosome isolation

Exosomes were isolated by the polymer formulation method [22] from blood serum using an ExoQuick reagent precipitation kit (System Biosciences, SBI, Mountain View, CA) according to the manufacturer’s protocol. This exosome isolation method has been well validated with other techniques, including electron microscopy [22, 23]. All exosomes were stored at –80°C immediately after isolation until further analysis. The total protein concentration of the isolated exosomes was determined using the standard Bradford protein assay (Bio-Rad, Richmond, VA, USA).

Isolation of RNA from exosomes

Exosome supernatants were added to 40 pM synthetic cel-miR-39 (UCACCGGGUGUAAAUCAGCUUG) to control and normalize the efficiency of RNA extraction; then, they were transferred to RNase-free tubes for RNA isolation using an miRNeasy Mini Kit (Qiagen, Valencia, CA, USA) according to the manufacturer’s protocol. The RNA sample was washed twice in 500 µl of RPE buffer and eluted in RNase-free water. The isolated RNA was measured using a NanoDrop 1000 ultraviolet spectrophotometer (Thermo Fisher Scientific) and analyzed by reverse transcription polymerase chain reaction (RT-PCR) followed by quantitative PCR (qPCR).

Serum and urine exosome circRNA sequencing

The total RNA was extracted and then was digested with DNase I to remove rRNA; then, RNase R was used to remove the linear RNA, enriching the circRNAs. The circRNAs were fragmented, and the first strand cDNA was synthesized by reverse transcription using random primers. Then, the second strand cDNA was synthesized using dNTP containing dUTP. The secondary chain product was subjected to terminal repair, and was pulsed “A” and a linker. The reaction mixture was digested with USER enzyme to remove the second strand cDNA containing dUTP, and a primer was added to amplify via PCR and obtain a chain-specific cDNA library. The fragments were screened by magnetic beads. Quality control was performed and fragments were further sequenced on a machine. The experimental procedure is summarized in Figure 1.

Figure 1.

Figure 1

The main experimental process of circular RNA gene sequencing. QC1: detection of the total RNA concentration, purity, completeness; QC2: confirmed that more than 99% of the rRNA had been removed; QC3: confirmed that RNA was fragmented into approximately 200-bp fragments; QC4: detected the fragment concentration and size and library concentration. The distribution of the significantly differentially expressed miRNA of cells in the cellular component with high throughput sequencing

Bioinformatics analysis

The expression values calculated for the differential proteins and peptides were used for the distance and average to determine the linkage for gene ontology (GO) analysis. In pathway analysis, interactions between genes in the range of genomes were analyzed by downloading the pathway data in KEGG. Finally, the results of the above data were merged into a comprehensive gene inter-relationship network. The established gene network could directly reflect the inter-relationships between genes at a whole-cell level as well as the stability of the gene regulatory network.

Statistical analysis

The back-spliced junction reads and linear mapped reads were combined and scaled to reads per million mapped reads (RPM) to quantify circRNA expression levels. Differences in circRNA expression levels were analyzed using Student’s t-test. P < 0.05 was considered statistically significant.

Results

Total RNA quality and concentration determination results

RNA was extracted and purified using an RNA isolation kit. The total RNA of the IMN and NC groups was detected with a Qubit3.0 fluorescence meter. The results are shown in Tables II and III. In the tables, the total amount of exosome RNA measured in each group was more than 200 ng, and the obtained circRNAs had high purity and good integrity, and could be used for later experiments.

Table II.

Concentration of exosome total RNA

Sample name Serum volume [ml] Exosome RNA concentration [ng/µl] Exosome RNA total amount [ng]
IMN group 28.7 9.69 242.30
NC group 23 33.40 400.80

IMN group – IMN group, NC group – normal control group.

Table III.

Concentration of exosome total RNA

Sample name Urine volume [ml] Exosome RNA concentration [ng/µl] Exosome RNA total amount [ng]
IMN group 980 16.50 445.50
NC group 970 16.70 367.40

IMN group – IMN group, NC group – normal control group.

Types of circRNAs

Compared with the healthy control group, the types of circRNAs in the serum of the patients with idiopathic membranous nephropathy decreased and mainly appeared as intron region sources. However, the circRNAs in the urinary exosomes increased, and mainly appeared to have an exon region source (Table IV).

Table IV.

Species of exosome circRNA

Variable IMN serum IMN urine NC serum NC urine
Total number of circRNAs 85 286 227 12
Number of circRNAs from the circBase database 0 198 6 1
Number of circRNAs from the exon region 5 218 12 2
Number of circRNAs from the intron region 60 58 189 6
Number of circRNAs from the intergenic region 20 10 26 1

IMN group – IMN group, NC group – normal control group.

Difference analysis of circRNAs

According to the expression level of circRNAs, when the difference multiple (ratio) was more than 2 or less than 0.5 and FDR ≤ 0.001, the circRNAs were considered differentiated. In this study, the log2 ratio was used instead of multiple differences. The filter criteria of significantly differentially expressed genes were FDR ≤ 0.001 and |log2 ratio| ≥ 1.

Differential expression of circRNAs in serum and urine exosomes of IMN patients

According to the experimental results, there were 59 species of circRNA with significantly different expression compared to serum and urine exosomes in IMN patients; 32 species were up-regulated (Table V) and 27 species were down-regulated (Table VI). Most of these circRNAs had an intron source. The corresponding genes were mainly SNORA25, SNORA31, SNORA51, SNORA75 and other nucleolus small RNAs. The log2 ratio of chrY: 13688616|13833086 was 27.592 in the up-regulation circRNA, which was the most significant. The log2 ratio of chrY:13842647|13855594 was –26.379 in the down-regulation circRNA, which was the most significant. However, the two most significantly different circRNAs in the circBase gene pool had no corresponding gene, suggesting that they may be newly discovered genes.

Table V.

Up-regulated circRNAs between the IMN serum and IMN urine

circRNA Log2 ratio Up/down CircRNA type Chromosome localization Gene localization
chrY:13688616|13833086 27.592 Up Intergenic region chrY n/a
chrY:13650802|13725921 26.677 Up Intergenic region chrY n/a
chrY:13844080|13851741 25.449 Up Intergenic region chrY n/a
chr3:114874721|114874739 24.936 Up Intron chr3 SNORA25
chr4:49133318|49151812 24.363 Up Intron chr4 SNORA75
chr4:49133318|49151817 23.766 Up Intron chr4 SNORA75
chr1:246981249|246981308 23.51 Up Intron chr1 SNORA25
chr6:39390231|39390251 23.444 Up Intron chr6 KIF6
chrY:13688616|13810318 23.251 Up Intergenic region chrY n/a
chrY:13867301|13869486 23.116 Up Intergenic region chrY n/a
chr3:42154842|42154889 23.059 Up Intron chr3 TRAK1
chr8:70602312|70602409 22.531 Up Intron chr8 SLCO5A1
chr4:49118019|49128722 22.398 Up Intron chr4 SNORA51
chr10:39103465|39105726 22.302 Up Intron chr10 SNORA31
chr8:70602353|70602431 22.029 Up Intron chr8 SLCO5A1
chr8:70602360|70602427 21.967 Up Intron chr8 SLCO5A1
chr10:39085864|39088295 21.903 Up Intron chr10 SNORA31
chr1:91853081|91853139 21.766 Up Intron chr1 SNORA31
chrY:13684026|13844079 21.614 Up Intergenic region chrY n/a
chr3:114874721|114874743 21.614 Up Intron chr3 SNORA25
chr8:70602355|70602427 21.531 Up Intron chr8 SLCO5A1
chr4:49637530|49641867 21.351 Up Intron chr4 SNORA51
chr4:49120156|49121084 21.351 Up Intron chr4 SNORA51
chr8:70602312|70602382 21.351 Up Intron chr8 SLCO5A1
chr17:22246001|22253301 21.351 Up Intron chr17 snoU13
chr21:10778969|10808326 21.251 Up Intron chr21 SNORA70
chr1:108113527|108113595 21.251 Up Intron chr1 SNORA31
chrY:13659053|13844079 21.144 Up Intron chrY n/a
chr15:101250552|101250653 21.144 Up Intron chr15 snoU13
chr21:44593818|44593903 21.144 Up Intergenic region chr21 n/a
chr7:100550808|100551062 4.267 Up Exon chr7 MUC3A
chrY:13805036|13841134 3.876 Up Intergenic region chrY n/a

NB: Gene ID n/a indicates that there was no matched circRNA in the circBase gene bank.

Table VI.

Down-regulated circRNAs between the IMN serum and IMN urine

circRNA Log2 ratio Up/down CircRNA type Chromosome localization Gene localization
chrY:13842647|13855594 –26.379 Down Intergenic region chrY n/a
chrY:13650802|13659298 –26.116 Down Intergenic region chrY n/a
chr17:22248380|22253301 –25.516 Down Intron chr17 snoU13
chr8:43092760|43093139 –25.146 Down Intron chr8 SNORD112
chr8:43092873|43096758 –24.588 Down Intron chr8 SNORD112
chr4:90986390|90986415 –24.441 Down Intron chr4 SNORA51
chr4:49103783|49111822 –23.791 Down Intron chr4 SNORA51
chr10:39139428|39147131 –23.244 Down Intron chr10 SNORA31
chr4:49641376|49652154 –23.221 Down Intron chr4 SNORA51
chr18:54265993|54266355 –23.079 Down Exon chr18 TXNL1
chr6:158779108|158779264 –22.894 Down Intron chr6 TULP4
chr2:19441309|19442090 –22.806 Down Intron chr2 SNORA51
chr3:96221435|96221837 –22.776 Down Intron chr3 SNORA25
chrY:13801063|13849765 –22.266 Down Intergenic region chrY n/a
chr8:43095798|43096720 –21.976 Down Intron chr8 SNORD112
chr6:61899754|61913064 –21.806 Down Intron chr6 SNORD45
chr8:43093689|43097076 –21.681 Down Intron chr8 SNORD112
chr2:233244474|233272478 –21.614 Down Intron chr2 snoU13
chr2:221311242|221311332 –21.543 Down Intron chr2 SNORA75
chr20:30954187|30956926 –21.543 Down Exon chr20 ASXL1
chr4:35172567|35172590 –21.469 Down Intron chr4 SNORA75
chr6:2024936|2340390 –21.391 Down Intron chr6 snoU13
chr10:18831781|18831900 –21.309 Down Intron chr10 SNORA31
chr10:42400571|42533897 –21.221 Down Intron chr10 SNORA31
chr15:30465080|30465505 –21.128 Down Intron chr15 SNORA48
chr19:34882415|34883413 –3.063 Down Intron chr19 GPI
chrY:13691698|13851741 –1.454 Down Intergenic region chrY n/a

NB: Gene ID n/a indicates that there was no matched circRNA in the circBase gene bank.

Differential expression of circRNAs in serum exosomes of IMN and NC patients

According to the experimental results, there were 89 species of circRNAs with significantly different expression compared to IMN patients’ serum exosomes and NC patients’ serum exosomes; 49 species were up-regulated (Table VII) and 40 species were down-regulated (Table VIII). Most of these circRNAs had an intron source. The corresponding genes were mainly SNORA25, SNORA51, SNORA31, SNORA75, SNORD112 and other nucleolus small RNAs. The log2 ratio of chrY:13688616|13833086 was 27.592 in the up-regulation circRNAs, which was the most significant. However, the circRNAs in the circBase gene pool had no corresponding gene, which suggested that it may be a newly discovered gene. The log2 ratio of chr2:233244474|233272478 was –27.111 in the down-regulation circRNAs, which was the most significant, and the corresponding gene is the snoU13 gene. This gene is mainly expressed nucleolus small RNA and plays a role in RNA treatment and modification.

Table VII.

Up-regulated circRNAs between the IMN and NC groups in serum

circRNA Log2 ratio Up/down CircRNA type Chromosome localization Gene localization
chrY:13688616|13833086 27.592 Up Intergenic region chrY n/a
chrY:13650802|13725921 26.677 Up Intergenic region chrY n/a
chr3:114874721|114874739 24.936 Up Intron chr3 SNORA25
chr4:49133318|49151812 24.363 Up Intron chr4 SNORA51
chr4:49133318|49151817 23.766 Up Intron chr4 SNORA51
chr6:39390231|39390251 23.444 Up Intron chr6 KIF6
chrY:13688616|13810318 23.251 Up Intergenic region chrY n/a
chr3:42154842|42154889 23.059 Up Intron chr4 TRAK1
chr4:49118019|49128722 22.398 Up Intron chr4 SNORA51
chr10:39103465|39105726 22.302 Up Intron chr10 SNORA31
chr10:39085864|39088295 21.903 Up Intron chr10 SNORA31
chr1:91853081|91853139 21.766 Up Intron chr1 HFM1
chrY:13684026|13844079 21.614 Up Intergenic region chrY n/a
chr3:114874721|114874743 21.614 Up Intron chr3 SNORA25
chr8:70602355|70602427 21.531 Up Intron chr8 SLCO5A1
chr4:49637530|49641867 21.351 Up Intron chr4 SNORA51
chr4:49120156|49121084 21.351 Up Intron chr4 SNORA51
chr17:22246001|22253301 21.351 Up Intron chr17 snoU13
chr21:10778969|10808326 21.251 Up Intron chr21 SNORA70
chr1:108113527|108113595 21.251 Up Intron chr1 SNORA51
chrY:13659053|13844079 21.144 Up Intergenic region chrY n/a
chr15:101250552|101250653 21.144 Up Intron chr15 snoU13
chr21:44593818|44593903 21.144 Up Intergenic region chr21 n/a
chr2:5845511|5845954 20.766 Up Intron chr2 snoU13
chr4:70296654|70296710 20.614 Up Intron chr4 SNORA51
chr7:71387989|71388027 20.614 Up Intron chr7 CALN1
chr16:47538682|47538754 20.614 Up Intron chr16 PHKB
chr19:34882415|34883413 20.444 Up Intron chr19 GPI
chr2:92305623|92309358 20.444 Up Intron chr2 SNORA75
chr20:59906635|59906776 20.251 Up Intron chr20 CDH4
chr1:91852914|91852996 20.029 Up Intron chr1 HFM1
chr10:38778641|38816581 20.029 Up Intron chr10 SNORA31
chrX:108297654|108297709 20.029 Up Exon chrX CTD-2328D6.1
chr12:38237430|38502951 20.029 Up Intron chr12 SNORD112
chr20:59906715|59906776 19.766 Up Intron chr20 CDH4
chr14:70396886|70396954 19.766 Up Intron chr14 SMOC1
chr8:70602368|70602431 19.766 Up Intron chr8 SLCO5A1
chr10:51358680|51636067 19.766 Up Intron chr10 SNORA31
chr8:70602312|70602420 19.766 Up Intron chr8 SLCO5A1
chr8:70602360|70602427 4.413 Up Intron chr8 SLCO5A1
chr1:246981249|246981308 3.955 Up Intron chr1 SNORA25
chr7:100550808|100551062 3.349 Up Exon chr7 MUC3A
chrY:13867301|13869486 2.807 Up Intergenic region chrY n/a
chrY:13805036|13841134 2.806 Up Intergenic region chrY n/a
chr8:70602353|70602431 2.567 Up Intron chr8 SLCO5A1
chrY:13691698|13851741 2.522 Up Intergenic region chrY n/a
chr8:70602312|70602409 2.276 Up Intron chr8 SLCO5A1
chrY:13844080|13851741 2.012 Up Intergenic region chrY n/a
chrY:13688616|13851691 1.936 Up Intergenic region chrY n/a

NB: Gene ID n/a indicates that there was no matched circRNA in the circBase gene bank.

Table VIII.

Down-regulated circRNA between the IMN and NC groups in serum

circRNA Log2 ratio Up/down CircRNA type Chromosome localization Gene localization
chr2:233244474|233272478 –27.111 Down Intron chr2 snoU13
chr17:39537965|39552828 –26.966 Down Intron chr17 SCARNA20
chr22:42910112|42970824 –26.895 Down Intron chr22 Y_RNA
chr6:31122297|31122344 –26.054 Down Exon chr6 CCHCR1
chr12:52863454|52909616 –25.798 Down Intron chr12 SNORD112
chr19:36066505|36066634 –25.772 Down Intron chr19 SNORA70
chr4:1005136|1242947 –25.454 Down Intergenic region chr4 n/a
chr4:159973545|159973572 –25.028 Down Intron chr4 SNORA51
chrY:13842647|13855594 –24.668 Down Intergenic region chrY n/a
chr21:37558665|37558690 –22.588 Down Intron chr21 DOPEY2
chr15:31645251|31645272 –22.461 Down Intron chr15 KLF13
chr10:39139428|39141998 –22.387 Down Intron chr10 SNORA31
chr17:39938846|39938869 –22.336 Down Intron chr17 JUP
chr17:22253135|22260437 –22.198 Down Intron chr17 snoU13
chr17:79502678|79502749 –21.981 Down Intron chr17 FSCN2
chr17:48266264|48272839 –21.912 Down Exon chr17 COL1A1
chr10:38804894|38818467 –21.894 Down Intron chr10 SNORA31
chr1:74953936|74953971 –21.858 Down Intron chr1 TMEM56
chr5:116075463|116075487 –21.764 Down Intron chr5 SNORA70
chr18:18518121|18519655 –21.764 Down Intron chr18 SNORD112
chr7:148028455|148028529 –21.744 Down Intron chr7 CNTNAP2
chr2:189121958|189121979 –21.724 Down Intron chr2 SNORA48
chrX:3349826|3349848 –21.642 Down Intron chrX snoU13
chr11:75979847|75979884 –21.599 Down Intron chr11 SNORA1
chr15:42134880|42134903 –21.509 Down Exon chr15 PLA2G4B
chr18:32291302|32291329 –21.387 Down Intron chr18 DTNA
chr13:36337738|36337787 –21.362 Down Intron chr13 SNORA25
chr17:31559413|31559527 –21.336 Down Intron chr17 ASIC2
chr9:19592476|19592555 –21.282 Down Intron chr9 SLC24A2
chr7:76626497|76626556 –21.282 Down Intron chr7 DTX2P1
chr8:124924619|124924638 –21.198 Down Intron chr8 FER1L6
chr1:7769121|7769144 –21.078 Down Intron chr1 CAMTA1
chr14:37211610|37211628 –21.046 Down Intron chr14 SLC25A21
chr1:32294226|32294254 –20.947 Down Intron chr1 SNORA70
chr17:31559408|31559527 –20.912 Down Intron chr17 ASIC2
chr19:56438931|56438947 –20.84 Down Intron chr19 NLRP13
chr1:155048684|155048737 –20.764 Down Intron chr1 EFNA3
chr20:46681136|46681159 –20.764 Down Intron chr20 snoU13
chr1:233454768|233454781 –20.764 Down Intron chr1 SNORA25
chr6:104238460|104238484 –3.592 Down Intron chr6 SNORA33

NB: Gene ID n/a indicates that there was no matched circRNA in the circBase gene bank.

Differential expression of circRNAs in urine exosomes of IMN and NC patients

According to the experimental results, there were 60 species of circRNAs with significantly different expression compared to IMN patients’ urine exosomes and NC patients’ urine exosomes; 54 species were up-regulated (Table IX) and 6 species were down-regulated (Table X). Approximately 55% were intron sources, 30% were exon sources and 15% were intergenic regions. The corresponding genes were mainly SNORA51, SNORA31, SNORA70, SNORA75, SNORD112 and other nucleolus small RNAs. The log2 ratio of chrY:13842647|13855594 was 26.379 in the up-regulated circRNA, which was the most significant. The log2 ratio of chrY:13688616|13833086 was –25.049 in the down-regulated circRNAs, which was the most significant. However, the two most significantly different circRNAs in the circBase gene pool had no corresponding gene, suggesting that they may be newly discovered genes.

Table IX.

Up-regulated circRNAs between the IMN and NC groups in urine

circRNA Log2 ratio Up/down CircRNA type Chromosome localization Gene localization
chrY:13842647|13855594 26.379 Up Intergenic region chrY n/a
chrY:13691698|13851741 26.006 Up Intergenic region chrY n/a
chr17:22248380|22253301 25.516 Up Intron chr17 snoU13
chr8:43092760|43093139 25.146 Up Intron chr8 SNORD112
chr8:43092873|43096758 24.588 Up Intron chr8 SNORD112
chr4:49103783|49111822 23.791 Up Intron chr4 SNORA51
chr19:34882415|34883413 23.507 Up Intron chr19 GPI
chr10:39139428|39147131 23.244 Up Intron chr10 SNORA31
chr4:49641376|49652154 23.221 Up Intron chr4 SNORA51
chr18:54265993|54266355 23.079 Up Exon chr18 TXNL1
chr6:158779108|158779264 22.894 Up Intron chr6 TULP4
chr2:19441309|19442090 22.806 Up Intron chr2 SNORA51
chr3:96221435|96221837 22.776 Up Intron chr3 SNORA25
chrY:13801063|13849765 22.266 Up Intergenic region chrY n/a
chr8:43095798|43096720 21.976 Up Intron chr8 SNORD112
chr6:61899754|61913064 21.806 Up Intron chr6 SNORD45
chr8:43093689|43097076 21.681 Up Intron chr8 SNORD112
chr2:233244474|233272478 21.614 Up Intron chr2 snoU13
chr2:221311242|221311332 21.543 Up Intron chr2 SNORA75
chr20:30954187|30956926 21.543 Up Exon chr20 ASXL1
chr4:35172567|35172590 21.469 Up Intron chr4 SNORA75
chr6:2024936|2340390 21.391 Up Intron chr6 snoU13
chr10:18831781|18831900 21.309 Up Intron chr10 SNORA31
chr10:42400571|42533897 21.221 Up Intron chr10 SNORA31
chr15:30465080|30465505 21.128 Up Intron chr15 SNORA48
chr21:10788458|10853762 21.029 Up Intron chr21 SNORA70
chr18:18518121|18519655 20.806 Up Intron chr18 SNORD112
chrY:13805036|13841134 20.806 Up Intergenic region chrY n/a
chr3:196118684|196129890 20.681 Up Exon chr3 UBXN7
chr5:137320946|137324004 20.543 Up Exon chr5 FAM13B
chr9:137976113|137976207 20.543 Up Intron chr9 OLFM1
chr4:49101961|49155306 20.543 Up Intron chr4 SNORA75
chr11:33307959|33309057 20.391 Up Exon chr11 HIPK3
chr17:20107646|20109225 20.221 Up Exon chr17 SPECC1
chr19:7034465|7036161 20.221 Up Intron chr19 Y_RNA
chr8:141874411|141900868 20.029 Up Exon chr8 PTK2
chr8:99718695|99719539 20.029 Up Exon chr8 STK3
chr13:64330137|64398060 20.029 Up Intron chr13 SNORA25
chr8:43093228|43097076 20.029 Up Intron chr8 SNORD112
chrY:13140123|13456953 20.029 Up Intergenic region chrY n/a
chr21:16386665|16415895 19.806 Up Exon chr21 NRIP1
chr10:32197100|32199491 19.806 Up Exon chr10 ARHGAP12
chr14:76633006|76662315 19.806 Up Exon chr14 GPATCH2L
chrY:13137990|13450019 19.806 Up Intergenic region chrY n/a
chr21:10789780|10836717 19.543 Up Intron chr21 SNORA70
chr2:61749746|61761038 19.543 Up Exon chr2 XPO1
chr5:72370569|72373320 19.543 Up Exon chr5 FCHO2
chr1:180953813|180962561 19.543 Up Exon chr1 STX6
chr2:228252617|228252643 19.543 Up Intron chr2 SNORA75
chr2:202010101|202014558 19.543 Up Exon chr2 CFLAR
chr20:52773708|52788209 19.543 Up Exon chr20 CYP24A1
chr9:113734353|113735838 19.543 Up Exon chr9 LPAR1
chr6:4891947|4892613 4.346 Up Exon chr6 CDYL
chrY:13650802|13659298 1.893 Up Intergenic region chrY n/a

NB: Gene ID n/a indicates that there was no matched circRNA in the circBase gene bank.

Table X.

Down-regulated circRNAs between the IMN and NC groups in urine

circRNA Log2 ratio Up/down CircRNA type Chromosome localization Gene localization
chrY:13688616|13833086 –25.049 Down Intergenic region chrY n/a
chr17:25267933|25267961 –23.323 Down Intron chr17 snoU13
chr10:39084961|39105726 –23.142 Down Intron chr10 SNORA31
chr10:38787997|39138199 –22.485 Down Intron chr10 SNORA31
chr14:105944010|105944069 –20.583 Down Intron chr14 CRIP2
chrY:13688616|13851691 –1.126 Down Intergenic region chrY n/a

NB: Gene ID n/a indicates that there was no matched circRNA in the circBase gene bank.

Bioinformatics analysis

Target genes were analyzed for their potential functions using GO and KEGG pathways. GO analysis demonstrated that the target genes were associated with cellular processes, multicellular organisms, pigmentation, the development process and the response to stimuli at both serum and urine exosomes (Figures 2 and 3). Furthermore, significantly associated pathways comprising the target genes were obtained for the assessed circRNAs. Interestingly, we selected 29 metabolic pathways in the serum sample; of all 29 pathways, 21 had PLA abnormalities, and the corresponding gene was PLA2G4B. The top 20 signaling pathways are shown in Figure 4, while the platelet activation signaling pathway was the most widely distributed (Figure 5). In addition, we selected 35 metabolic pathways in the urine samples. The top 20 are shown in Figure 6, while the P13K-Akt signaling pathway was the most widely distributed (Figure 7).

Figure 2.

Figure 2

GO annotation of differentially expressed circRNAs in the serum exosomes of IMN patients compared to the control group. GO annotation consisted of the biological process, cellular components, and molecular function

Figure 3.

Figure 3

GO annotation of differentially expressed circRNAs in urine exosomes of IMN patients compared to the control group. GO annotation consisted of the biological process, cellular component, and molecular function

Figure 4.

Figure 4

KEGG pathway analysis of predicted targets for differentially expressed circRNAs in serum exosomes of IMN patients compared to the control group. The bluer the circle, the more significant the pathway enrichment. The bigger the circle, the higher the number of pathway genes

Figure 5.

Figure 5

Pathway analysis of differential genes: platelet activation. Red marks indicate the genes with differential profiles

Figure 6.

Figure 6

KEGG pathway analysis of predicted targets for differentially expressed circRNAs in urine exosomes of IMN patients compared to the control group. The bluer the circle, the more significant the pathway enrichment. The bigger the circle, the higher the number of pathway genes

Figure 7.

Figure 7

Pathway analysis of differential genes: the PI3K-Akt signaling pathway. Red marks indicate the genes with differential profiles

Discussion

Beck et al. [24] detected anti-PLA2R antibodies for the first time in IMN patient plasma samples. Substantial clinical data showed its specificity of up to 100% and sensitivity of approximately 70% to 80%, which indicated that they can be used as IMN-specific diagnostic markers.

The latest study [24, 25] showed that the mannose-binding lectin pathway was the major complement activation in the pathogenesis of IMN. In this study, the mucin 3A (MUC3A) gene, corresponding to the circRNAs of chromosome 7 encoding chr7: 100550808|100551062 in the serum exosomes of IMN patients, was significantly up-regulated. It was also found that MUC3A was encoded by an exon-derived gene. Existing studies have shown that [26] MUC3A is a mucin cluster located on the 7p22 chromosome. Additionally, MUC3A belongs to a transmembrane glycoprotein. Authors [27] found that 71% of the amino acid repeated sequences encoded by MUC3 were serine/threonine and 6% proline. Studies have demonstrated that the activation of serine proteases is achieved by a change in specific amino acid residues in the center of serine-dominated activity [28]. Because most of the amino acids encoded by the MUC3A gene in this study were serine/threonine, we speculate that the MUC3A gene may encode the relevant amino acids and then play an important role in the pathogenesis of IMN through the mannose-binding lectin pathway. Previous evidence suggests that PLA2R-IgG4 can play a role by activating the complement lectin pathway with MBL [29]. The serine of the MUC3A gene also plays a role in the lectin binding pathway. Therefore, we further speculated that the MUC3A gene may be associated with IgG4 and anti-PLA2R antibody expression. There were some relationships in the diagnosis and prognosis of IMN. In addition, it was reported [30] that MUC3A is a class of membrane-associated mucins, which can mediate some of the particles and related pathogens adhering to the mucosal surface. Additionally, MUC3A is involved in binding of the receptor and ligand and signal transduction pathways. MUC3A can mediate the adhesion of the relevant particles to the membrane surface and participate in the receptor ligand binding process, suggesting that MUC3A may also play a role in the formation of immune complexes.

In addition, in this experiment, the genes for which we observed a significant difference in the circRNAs are mainly intron-derived circRNAs. The corresponding genes are SNORA25, SNORA31, SNORA70, SNORA75, SNORD112 and other small nucleolar RNAs (snoRNAs). An increasing number of studies have shown that snoRNAs can be further processed to form shorter RNA fragments, and these short fragments of snoRNAs have microRNA-like functions. This finding suggested that snoRNAs may act as microRNA precursors [31]. One study [32, 33] showed that circRNAs of different gene sources exist in different parts of the cell and the function is also different. The corresponding genes of circRNAs that we obtained in this experiment were mainly the intron source for coding snoRNAs. Therefore, we speculate that in the pathogenesis of IMN at the gene level, the circRNAs of the intron source may code snoRNAs that modify the mRNA during and before transcription as well as regulating the gene expression at the mRNA level.

Studies have shown that alleles-PLA2R1 and HLA-DQA1 are closely related to IMN [34]. In this study, we selected 29 metabolic pathways in the serum sample; 21 had PLA abnormalities. IMN does not appear to occur through a specific signaling pathway; instead, several pathways appear to work at the same time. Additionally, the corresponding gene of PLA was PLA2G4B, which corresponds to PLA2R positivity in IMN patients. IMN may be associated with the PLA2G4B gene. Therefore, evaluation of PLA2G4B may provide new clues for the diagnosis and treatment of IMN.

In conclusion, we found that there were abnormal expression levels of circRNAs in serum and urine exosomes in IMN patients. These circRNAs with abnormal expression could be involved in IMN pathogenesis. However, the specific mechanism and function of the circRNAs with differential expression in the disease require more direct evidence. However, with the continuous development of biological technology and continuous research on circRNAs, circRNAs will eventually provide a new theoretical basis in the disease diagnosis, treatment and prognosis. Additionally, the study of PLA2G4B may provide new clues for the diagnosis and treatment of IMN.

Acknowledgments

This study was financially supported by the Shenzhen Science and Technology Innovation Committee (grant no. JCYJ20160422151707152). This article used an English Language Service by American Journal Experts.

Hualin Ma and Ying Xu contributed equally to the work.

Conflict of interest

The authors declare no conflict of interest.

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