Urinary Collagen Peptides Predict Mortality

Area of Science:

• Biomarkers
• Proteomics
• Organ Fibrosis

Background:

• Organ fibrosis, driven by excessive extracellular matrix (ECM), is linked to mortality.
• Urinary peptide signatures, largely collagen fragments, predict mortality in SARS-CoV-2 and chronic kidney disease.

Purpose of the Study:

• To investigate if urinary collagen peptides, indicative of organ fibrosis, can predict mortality in critical and non-critical patient conditions.

Main Methods:

• Analyzed urinary proteomic data from 1012 patients (CRIT-COV-U study) for collagen peptide association with short-term mortality.
• Validated findings in independent datasets of 9193 patients (ICU and non-ICU).
• Developed and validated a collagen peptide classifier (COL210) for mortality prediction.

Main Results:

• 607 collagen peptides significantly associated with mortality.
• The COL210 classifier demonstrated strong mortality prediction in ICU (HR: 2.64) and non-ICU (HR: 2.16) patients.
• Mortality prediction was consistent across diverse underlying conditions.

Conclusions:

• Urinary collagen fragments are linked to increased mortality risk.
• A non-invasive, collagen-based urinary biomarker can predict mortality.
• This finding may facilitate proteomics-guided interventions for fibrosis.