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PhD Studentship

Development of urinary exosomes as biomarkers of drug-induced kidney injury

A stock image of round glass dishes containing blue and green liquid arranged closely together.

At a glance

Award date
October 2013 - September 2016
Grant amount
Principal investigator
Dr James Dear
University of Edinburgh


  • Reduction
  • Refinement
Read the abstract
View the grant profile on GtR



This project aims to develop the use of urinary exosomes as a non-invasive approach to assessing renal toxicity.


Renal toxicity is estimated to account for around 2% of drug attrition in preclinical development and 19% in phase III clinical trials. Improving the identification of kidney toxicity and to ensuring better translation of biomarkers has the potential to reduce and refine the use of animals.

Damage to the kidneys as a result of drug toxicity is assessed as part of preclinical studies in animals. They tend not to be standalone studies unless a specific toxicity has been identified which requires further investigation. Assessment typically focuses on circulating biomarkers of kidney damage such as serum creatinine levels and post-mortem tissue analysis, however, these provide little information on the cellular site of injury or the underlying pathophysiology.

The use of urinary exosomes provides an opportunity to non-invasively investigate renal toxicity. This has a number of 3Rs advantages; early signs of renal toxicity should allow decisions to be made to terminate studies before animals suffer, and longitudinal studies in the same animal should be possible allowing animals to be used as their own control. Importantly, improved biomarkers which translate to the clinic should allow drugs to be dropped earlier in the pipeline before the extensive animal testing required to support late stage clinical trials.

Research details and methods

Exosomes are nanoparticle-sized vesicles which transport a range of molecules including microRNAs. They are derived from derived from a range of cells and released into blood and urine. This research aims to investigate whether rat urinary exosomes can be used as a non-invasive marker of renal toxicity.

Urinary exosomes have been shown to capsulate microRNA originating from the glomerulus and nephron. Recent evidence suggests that microRNAs are mediators of drug toxicity and therefore may provide potential biomarkers of cell injury. The research will explore the utility and reproducibility of urinary exosomes for analysis of kidney toxicity. It will employ nanoparticle tracking analysis technology and antibody labelling to identify exosome concentration and cellular origin.

Application abstract

A major reason why new drugs, that are promising in models of disease, do not reach patients is that they are toxic to the kidneys. To detect kidney damage and allow the safe design of human clinical drug trials the use of animals is essential. At present it is necessary to harvest kidney tissue from culled animals to identify which part of the kidney is injured and measure changes in key toxicity pathways. We propose to develop tiny particles released into the urine (exosomes) as a non-invasive alternative to using kidney tissue. This will reduce the number of animals used in kidney toxicity studies, and improve the quality of the studies, by allowing repeat measurements in the same animal and facilitate direct translation of rodent toxicity signals into human clinical trials. Specifically, we will use a new technology called nanoparticle tracking analysis (NTA) to determine if the number or cellular origin of rat urinary exosomes changes following exposure to the toxic cancer drug cisplatin. Exosomes are packets of information, for instance they contain microRNA, a new class of marker for drug induced organ injury. We will determine if the microRNA in exosomes changes when kidney tissue microRNA is up-regulated by drug toxicity – i.e. can exosomes replace the need for tissue? Finally, exosomes can transfer their information between cells. Using a cell model in place of animals, we will explore the mechanism of this new cell to cell signalling process.



  1. Th'ng F et al. (2018). Evaluation of plasma microRNA-122, high-mobility group box 1 and keratin-18 concentrations to stratify acute gallstone disease: a pilot observational cohort study in an emergency general surgery unit. BMJ Open 8(4):e020061. doi: 10.1136/bmjopen-2017-020061
  2. Rivoli L et al. (2017). The effect of renal dysfunction and haemodialysis on circulating liver specific miR-122. British Journal of Clinical Pharmacology 83(3):584-92. doi: 10.1111/bcp.13136
  3. Rissin DM et al. (2017). Polymerase-free measurement of microRNA-122 with single base specificity using single molecule arrays: Detection of drug-induced liver injury. PloS One 12(7):e0179669. doi: 10.1371/journal.pone.0179669
  4. Vliegenthart A et al. (2017). Circulating acetaminophen metabolites are toxicokinetic biomarkers of acute liver injury. Clinical Pharmacology and Therapeutics 101(4):531-40. doi: 10.1002/cpt.541
  5. Vliegenthart ADB et al. (2017). Characterization of Triptolide-Induced Hepatotoxicity by Imaging and Transcriptomics in a Novel Zebrafish Model. Toxicological Sciences 159(2):280-91. doi: 10.1093/toxsci/kfx144
  6. Vliegenthart ADB et al. (2017). MicroRNA-122 can be measured in capillary blood which facilitates point-of-care testing for drug-induced liver injury. British Journal of Clinical Pharmacology 83(9):2027-33. doi: 10.1111/bcp.13282
  7. McCrae JC et al. (2016). Ethanol consumption produces a small increase in circulating miR-122 in healthy individuals. Clinical Toxicology 54(1):53-5. doi: 10.3109/15563650.2015.1112015
  8. Vliegenthart AD et al. (2015). Comprehensive microRNA profiling in acetaminophen toxicity identifies novel circulating biomarkers for human liver and kidney injury. Scientific Reports 5:15501. doi: 10.1038/srep15501
  9. Liga A et al. (2015). Exosome isolation: a microfluidic road-map. Lab on a Chip 15(11):2388-94. doi: 10.1039/c5lc00240k
  10. Vliegenthart AD et al. (2015). Target biomarker profile for the clinical management of paracetamol overdose. British Journal of Clinical Pharmacology 80(3):351-362. doi: 10.1111/bcp.12699
  11. Vliegenthart AD et al. (2014). Retro-orbital blood acquisition facilitates circulating microRNA measurement in zebrafish with paracetamol hepatotoxicity. Zebrafish 11(3):219-26. doi: 10.1089/zeb.2013.0912
  12. Vliegenthart AD et al. (2014). Zebrafish as model organisms for studying drug-induced liver injury. British Journal of Clinical Pharmacology 78(6):1217-27. doi: 10.1111/bcp.12408