{
  "abstract": "BackgroundFibrosis, characterised by excessive accumulation of collagen type I (COL1), is a common feature of chronic diseases, including liver diseases (LDs), chronic kidney disease (CKD) and heart failure (HF). COL1 degradation products can be detected in urine by proteomics/peptidomics analyses and may serve as non-invasive biomarkers of fibrosis. We aimed to identify a common molecular signature of fibrosis across these diseases that may ultimately guide interventions to slow disease progression and prevent organ damage.\n\nMethodsUsing capillary electrophoresis coupled to mass spectrometry (CE-MS), naturally occurring COL1 degradation products (peptides) in the urine of patients with fibrotic disease, LDs (n=127), CKD (n=263) or HF (n=187), were investigated and compared with the same number of matched controls. Disease-associated COL1 peptides were identified separately for each condition, and peptides showing consistent associations across the three diseases were selected to define a common fibrosis signature. A support vector machine model based on the selected peptides was developed and validated in independent cohorts of patients with LDs (n=110), CKD (n=93), HF (n=32) and controls (n=643).\n\nResultsWe identified a common fibrotic signature consisting of 50 COL1 degradation products, mainly downregulated in fibrosis. A model based on these peptides achieved a strong performance, with an area under the receiver operating characteristic curve (AUC) of 0.935 (95% confidence interval (CI) 0.917-0.953, p<0.0001) in an external validation cohort comprising pooled disease groups (LDs, CKD, and HF) and controls. Performance was maintained in LDs, CKD and HF, with AUCs of 0.917 (95% CI 0.890-0.944, p<0.0001), 0.951 (95% CI 0.931-0.971, p<0.0001) and 0.950 (95% CI 0.903-0.997, p<0.0001), respectively. The model scores were significantly associated with fibrosis stage in LDs (p=0.0097) and with interstitial fibrosis and tubular atrophy in CKD (p=0.045).\n\nConclusionA model of urinary COL1 peptides captures a shared collagen degradation signature across organs and diseases, enabling the non-invasive assessment of fibrosis irrespective of its origin. As these peptides exclusively reflect collagen degradation, the findings suggest impaired collagen degradation as a driver in fibrosis. Future clinical studies are warranted to evaluate the utility of this model for early fibrosis detection and earlier implementation of anti-fibrotic interventions.",
  "abstract_shown": true,
  "affiliations": [
    "Mosaiques Diagnostics GmbH"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "name": "I. K. Mina"
    },
    {
      "name": "Y. Hussain"
    },
    {
      "name": "J. Siwy"
    },
    {
      "name": "L. Catanese"
    },
    {
      "name": "H. Rupprecht"
    },
    {
      "name": "J. Beige"
    },
    {
      "name": "J. A. Staessen"
    },
    {
      "name": "J. Metzger"
    },
    {
      "name": "F. Persson"
    },
    {
      "name": "P. Rossing"
    },
    {
      "name": "C. Delles"
    },
    {
      "name": "J. P. Schanstra"
    },
    {
      "name": "A. Bannaga"
    },
    {
      "name": "A. Vlahou"
    },
    {
      "name": "H. Mischak"
    },
    {
      "name": "R. P. Arasaradnam"
    },
    {
      "affs": [
        0
      ],
      "name": "A. Latosinska"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/23dze9t0skf5t.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.26.26361420",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.26.26361420v1.full",
  "id": "23dze9t0skf5t",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.26.26361420v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "nephrology"
    ],
    [
      "openalex",
      "2727|Chronic Kidney Disease and Diabetes"
    ]
  ],
  "openalex": "W7204832314",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.26.26361420v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-26",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/23dze9t0skf5t.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:25Z",
      "native_id": "10.64898/2026.08.26.26361420",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.26.26361420v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:nephrology",
      "subfield": "general"
    }
  ],
  "title": "Urinary collagen type I degradation products as common fibrosis biomarkers in chronic diseases",
  "title_text": "Urinary collagen type I degradation products as common fibrosis biomarkers in chronic diseases",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:35Z",
  "url": "https://research.draconitic.com/paper/23dze9t0skf5t",
  "venue": "medRxiv",
  "versions": [
    {
      "doi": "10.1186/s10020-026-01648-5",
      "pid": null,
      "relation": "published-as",
      "title": null,
      "venue": null
    }
  ]
}