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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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using capillary electrophoresis coupled to mass spectrometry (CE-MS), naturally occurring COL1 degradation products (peptides) in the urine of patients with fibrotic disease, LDs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009127), CKD (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009263) or HF (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009187), 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                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009110), CKD (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200993), HF (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932) and controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009643).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We 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\u20130.953,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) 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\u20130.944,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), 0.951 (95% CI 0.931\u20130.971,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and 0.950 (95% CI 0.903\u20130.997,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), respectively. The model scores were significantly associated with fibrosis stage in LDs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0097) and with interstitial fibrosis and tubular atrophy in CKD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s10020-026-01648-5","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:45:27Z","timestamp":1790167527000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Urinary collagen type I degradation products as common fibrosis biomarkers in chronic diseases"],"prefix":"10.1186","volume":"32","author":[{"given":"Ioanna K.","family":"Mina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqza","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justyna","family":"Siwy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Catanese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Rupprecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Beige","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan A.","family":"Staessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Metzger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Persson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Delles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost P.","family":"Schanstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Bannaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Vlahou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Mischak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh P.","family":"Arasaradnam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Latosinska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"1648_CR1","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1007\/s13679-024-00574-z","volume":"13","author":"F Abdelhameed","year":"2024","unstructured":"Abdelhameed F, Kite C, Lagojda L, Dallaway A, Chatha KK, Chaggar SS, et al. 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For the CKD cohorts the local ethics committee of the Friedrich-Alexander Universitaet Erlangen-Nuernberg provided approval for the nephrological biobank of the Klinikum Bayreuth (ethic approval code 264_20 B) and the urinary proteomics analysis (ethic approval code 221_20 B). For the liver cohort (TENDENCY), the study was approved by Northeast-York research ethics committee, REC reference 19\/NE\/0213, IRAS project ID 260179. For the cohort from Bannaga et al.: the study was approved by Coventry and Warwickshire and North East-York Research National Health Service Ethics Committees UK (Reference numbers 09\/H1211\/38 and 19\/NE\/0213), and Ethics Committee of the Medical School Hannover (Reference number: 901). For the HFpEF cohort approval was provided by the ethics committee of the University Aachen (EK163\/19). In addition, ethical review and approval were not required for this study due to all data being fully anonymized, based on the opinion of the ethics committee of the Hannover Medical School, Germany (no. 3116\u20132016).","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"HM is the co-founder and co-owner of Mosaiques Diagnostics (Hannover, Germany). AL, and JS are employed currently by Mosaiques Diagnostics and IM was employed by Mosaiques Diagnostics. The remaining authors have no conflicts of interest to declare.","order":3,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"158"}}