Nanoparticles have potential applications in imaging, drug delivery and other types of therapy and diagnostics
1. Exosomes are naturally occurring bio-nanoparticles, that have substantial interest for disease biomarker applications and their properties and applications are being investigated extensively
2–4. Exosomes possess unique structural, surface biochemical and mechanical characteristics. Human saliva exosomes secreted by normal cells into saliva via exocytosis, are potential novel biomarkers showing tumor-antigen enrichment during oral cancer, the 6
th most frequent cancer worldwide and represents 5% of newly diagnosed cancers in adult patients.
5 In US, more than 50,000 new cases and 10,000 Head and Neck Squamous Cell Carcinomas (HNSCC) cancer-related deaths are projected annually.
5 Although HNSCC is a potentially curable malignancy with early diagnosis; patients are often diagnosed at a locally advanced 3
rd or 4
th (less to more advanced stage and type of cancer) grade of disease.
5 Between 60–70% of those advanced-stage patients will develop loco-regional recurrences within 2 years. After standard therapy, including surgical resection and adjuvant radiation, the 5-year survival rate for advanced-stage disease is less than 30%
6 and has remained unchanged over the past 20 years.
6, 7 Survival rate is dependent on stage at diagnosis with a 5-year overall survival of 82% for localized disease, 48% for regional disease, and 26% for distant disease. These statistics clearly indicate an urgent need for discovery of new diagnostic modalities for oral cancer.
Non-invasive saliva biomarkers for diagnostic and prognostic assessments have been established in recent years.
8 In particular, exosomes, small nano-vesicles (<100 nm in size) released from various cells including whole saliva, have been the subject of renewed interest, because these vesicles offer promising potential for diagnostics as well as therapeutics.
9, 10 Exosomes, considered for a long time to be artifacts, are now recognized to be important in cell-cell communication and other significant biological processes, such as membrane trafficking, intercellular horizontal transfer of proteins and RNAs.
11, 12 Malignancy and other diseases cause elevated exosome secretion and enrichment of tumor-antigen in exosomes is often associated with cancer cells.
13, 14 Recent reports indicate that the presence of exosomes of likely tumor origin in plasma and other biological fluids from cancer patients.
15–17 Recently, we have shown that human whole saliva contains secretory exosomes and identified their transcriptomic contents
18 and biophysical characteristics.
19 Exosomes possess highly specific surface composition and cargoes- proteins, RNA and DNA, it is likely that tumor-derived exosomes may differ from normal exosomes in certain physiological conditions, both in terms of structure and surface molecular characteristics. Exosomes released by normal and tumor cells have been suggested to differ in both functional and structural properties
20 implicating their direct role in pathogenesis, which could consequently serve as an important cancer biomarker. Currently exosomes use for diagnostic and therapeutic purposes
21, 22 mostly rely on bulk proteomic and genomic transcripts including previously reported over-expression of CD63, significantly associated with exosomes in biological fluids such as plasma of cancer patients.
23 However, single molecular studies of exosomes derived from cancer patients remain elusive.
Although exosomes hold promise as biomarkers for cancer diagnosis
21, 22, their nanoscale dimensions require sensitive, quantitative high-resolution detection tools for characterization on an individual basis
24. Information on single exosomes via conventional semi-quantitative proteomic and transcriptional analytical methods prove ineffective due to sensitivity limitations. Current paradigms of exosomes analysis include Electron Microscopy (EM), Western blot, Flow Cytometry and Mass Spectrometry.
25–27 Typically, EM imaging is used for identification of exosomes revealing apparent two-dimensional cup-shaped vesicles.
27 Due to their sub-100nm size, exosomes are difficult to detect as discrete particles and require sizing beads which challenges the sensitivity limit of ~100nm for flow cytometers.
28 AFM can characterize biological surfaces with sub-nanometer resolution and allows structural, biochemical and mechanical characterization of cells
29, 30, biological molecules
31 including vesicles
32, 33. AFM based single-molecule force spectroscopy (SMFS) mode could be used as a rapid and reliable tool to provide information on the morphology as well as on the molecular recognition abilities of biological interfaces such as exosomes, down to the single-molecule level. Previously, we have shown the single vesicle structural and surface molecular details on normal human saliva exosomes using AFM and high resolution FESEM.
19 The structural and bio-molecular changes in cancer saliva exosomes have not been reported. Here, we specifically report an AFM based assay for the identification of changes in exosome morphology and expression of bio-molecular surface receptor CD63 to detect single vesicle quantitative differences between normal and cancer human derived saliva exosomes. We present (1) Three dimensional ultra-structural characteristics and enumeration for isolated saliva exosomes using AFM imaging in air and (2) determine quantitative single exosomes surface receptor density of membrane marker CD63 under physiological buffer conditions, to elucidate structural and surface bio-molecular differences between the exosomes populations.