Exosomal Protein Profiles as Novel Biomarkers in Weight Gain After Kidney Transplantation: A Pilot Study

Purpose: Weight gain after kidney transplantation is a critical factor that can lead to poor outcomes with cardiovascular complications. Many studies have been conducted to identify predictive markers of future weight changes at the time of transplant. Recently, circulating exosomes and its contents including miRNAs and proteins have attracted attention as potential biomarkers. In this pilot study, we investigated exosomal proteins and weight change after kidney transplant. Methods: Recipients (n = 10) were classified into two groups; weight gainers (n= 5, 9.7± 4.4kg) and weight losers (n= 5,-6.4± 1.8kg) based on their weight changes at 12-months post-transplant. Based on the exosomal protein profiles obtained by the LC-MS/MS, differentially expressed proteins were identified between the groups. Results: Concentration and the mean size of exosomes significantly increased at 12-months compared to the baseline (p= .009) in the total group. Eleven exosomal proteins were found at the baseline as differentially expressed between the two groups. In the weight gain group, complement proteins including HV169, C3, C4B, and C4A, were significantly upregulated. Conclusion: Our pilot study suggests that exosomal complementary proteins are associated with weight gain after kidney transplantation. Further studies are needed to clarify the role of these exosomal proteins in the underlying mechanisms of weight changes in kidney transplant recipients.