Patent Publication Number: US-2020300849-A1

Title: Nanosensors and methods for detection of biological markers

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application claims the priority benefit of U.S. Provisional Patent Application Ser. No. 62/313,511, filed Mar. 25, 2016, entitled Methods and System for Collecting, Processing, Profiling, and Multi-sense Detection of Biological Markers within a Biological Sample, incorporated by reference in its entirety herein. 
    
    
     FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     This invention was made with government support under Contract No. UL1 TR001439 awarded by the National Institutes of Health, and Contract Nos. 1159966, 1242765, and 1411993 awarded by the National Science Foundation. The government has certain rights in the invention. 
    
    
     SEQUENCE LISTING 
     The following application contains a sequence listing in computer readable format (CRF), submitted as a text file in ASCII format entitled “SequenceListing,” created on Mar. 23, 2017, as 21 KB. The content of the CRF is hereby incorporated by reference. 
     BACKGROUND OF THE INVENTION 
     Field of the Invention 
     The present invention relates to nanosensors and instruments (e.g., microfluidics and optical sensors) and detection techniques (e.g., multiplexing) for detecting target biological markers in a specimen collected from a subject. 
     Description of Related Art 
     Inflammation is a protective response of the body to cellular damage and tissue injury. Under normal and controlled conditions, the role of this process is to remove the injurious agents while promoting wound healing and repair. However, under uncontrolled conditions, inflammatory responses can lead to excessive cellular damage resulting in chronic inflammation and destruction of normal tissue. Inflammatory airway and lung diseases, such as asthma, chronic obstructive pulmonary disease (COPD), or lung injury are characterized by chronic inflammation, fibrosis, and airway remodeling. Asthma affects the health of 26 million people, including 7 million children in the United States. It is characterized by repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. In 2010, 1.8 million people visited an ED for asthma-related care, and 439,000 people were hospitalized because of asthma. The human airway is continuously exposed to microorganisms, gases and allergens. As a result, the airway lining epithelial cells form the first line of defense against these environmental insults through a barrier function and secretion of protective proteins and molecules. The barrier function is the result of an impermeable barrier of lining cells connected by tight junctions, which serves to prevent organisms from invading the airway and to prevent fluid losses. The spectrum of secreted epithelial molecules is different for various regions of the lung as a consequence of the specialized cell types. For example, upper airway ciliated epithelial cells produce protective epithelial lining fluid rich in antioxidants. Pseudostratified tracheal airway cells secrete protective mucins to facilitate mucociliary particulate clearance, while lower alveolar epithelial cells. 
     In both children and adults, viral infections trigger asthma exacerbations by stimulating inflammatory gene expression programs in infected epithelium. These viruses include Respiratory Syncytial Virus (RSV)/human metapneumoviruses in children and Rhinovirus in adults. RSV infections of the small airways (bronchioles) is the most common cause of lower respiratory tract infections in children, infecting virtually all children by the age of 3. A recent prospective, population-based study of 5000 children presenting for acute medical care estimated that 18% of acutely ill children have acute RSV infection. Here it was observed that the presence of RSV infection produces 3-times the risk of subsequent hospitalization over that seen in infections with other common cold viruses, and in young children, hospitalization rates are 17 per 1000 babies. 
     Overall, ˜120,000 hospitalizations for bronchiolitis are seen in the US annually. RSV is the leading cause of infant viral death. Rhinovirus is the most common cause of viral respiratory tract infections in adults, and is responsible for exacerbations of asthma in this population. 
     There is a continuing need for rapid detection of clinically relevant biological markers indicative of diseased states or conditions, or for monitoring of disease progression and the response of the airway to therapeutic intervention as progress is being made toward the development of personalized medicine. 
     Cytokines are small proteins (˜5-20 kDa) that are important in cell signaling. Cytokine release has an effect on the behavior of cells around them. Cytokines are also involved in autocrine signaling, paracrine signaling and endocrine signaling as immunomodulating agents. The term “cytokine” includes chemokines, interferons, interleukins, lymphokines, and tumor necrosis factors. They are produced by macrophages, B lymphocytes, T lymphocytes as well as endothelial cells, fibroblasts, and various stromal cells. Cytokines modulate the balance between humoral and cell-based immune responses. There are both pro-inflammatory cytokines and anti-inflammatory cytokines. Pro-inflammatory cytokines include IL-1β, Interleukin 6 (IL-6), and TNF-α, which are involved in the process of pathological pain. Anti-inflammatory cytokines include IL4, IL-10, IL-13 and IFN-alpha. Macrophage Inflammatory Protein-3 (MIP3A) is another small cytokine belonging to the CC chemokine family. It is strongly chemotactic for lymphocytes and weakly attracts neutrophils. CCL20 is implicated in the formation and function of mucosal lymphoid tissues. IL-6 acts as both a pro-inflammatory cytokine and an anti-inflammatory myokine. IL-6 is secreted by T cells and macrophages to stimulate immune response. It also plays a role in fighting infections, Atherosclerosis, Depression, Alzheimer&#39;s Disease, Systemic lupus erythematosus, Prostate cancer, and Rheumatoid arthritis. Thus, it is a strong candidate for biomarker detection for a variety of diseases and condition. Thymic stromal lymphopoietin (TSLP) plays an important role in the maturation of T cell populations through activation of antigen presenting cells. Produced mainly by non-hematopoietic cells such as fibroblasts, epithelial cells and different types of stromal or stromal-like cells. Expression is linked to many disease states including asthma, inflammatory arthritis, atopic dermatitis and other allergic states. Further, co-expression of various markers, such as cytokines and MMPs can be used to detect and monitor condition progression. There is a need for techniques and instruments capable of such co-detection, which would greatly improve specificity and the diagnostic power of collected patient specimen. 
     SUMMARY OF THE INVENTION 
     The present invention is broadly concerned with nanosensors, microfluidic devices, and detection techniques for capturing, detecting, and quantifying biological markers in biospecimens collected from a subject (typically but not necessarily a mammalian subject, and usually a human patient, although veterinary uses are contemplated, such as in dogs, cats, horses, pigs, monkeys, rodents, etc.). 
     In one aspect, described herein are methods of microfluidic detection of a biological marker in a biological sample collected from a subject. The methods generally comprise analyzing a biological sample with a microfluidics device. The microfluidic devices comprise a cartridge and a planar substrate retained in the cartridge. The cartridge comprises a sample inlet well formed in the cartridge above a sample application region in or on the substrate and at least one detection region in fluid communication with the sample application region via a microfluidic channel extending from the sample application region to the detection region. The microfluidic channel has a terminal end positioned distal from the inlet well, and an optional absorbent pad positioned at the terminal end (to facilitate flow of the sample completely through the channel). The detection region comprises a first nanosensor immobilized therein or thereon. The nanosensor comprises a central carrier particle, a first particle tethered to the carrier particle via an oligopeptide linkage, and a second particle directly attached to the carrier particle, wherein at least one of the first and second particles is a detectable particle and the other of the first and second particles is a quencher particle. The oligopeptide linkage comprises a supramolecular recognition sequence, a protease consensus sequence, a post-translationally modifiable sequence, or a sterically hindered benzylether bond for specific interaction with the target biological marker. The biological sample collected from the subject is introduced into the inlet well and the biological sample flows to the terminal end along the microfluidic chamber, wherein the biological sample contacts the detection region before reaching the terminal end. The detection region is exposed to an energy source to generate a detectable signal from the detectable particle in the first nanosensor, and changes (e.g., decrease or increase in signal, appearance of new signal, etc.) in the detectable signal are detected based upon interaction of the biological sample (and more specifically the target marker, if present in the sample) with the first nanosensor. 
     Microfluidic devices are also described herein. The microfluidic devices general comprise a cartridge and a planar substrate retained in the cartridge. The cartridge comprises a sample inlet well formed in the cartridge above a sample application region in or on the substrate and at least one detection region in fluid communication with the sample application region via a microfluidic channel extending from the sample application region to the detection region. The microfluidic channel has a terminal end positioned distal from the inlet well, and an optional absorbent pad positioned at the terminal end (to facilitate flow of the sample completely through the channel). The detection region comprises a nanosensor immobilized therein or thereon. The nanosensor comprises a central carrier particle, a first particle tethered to the carrier particle via an oligopeptide linkage, and a second particle directly attached to the carrier particle, wherein at least one of the first and second particles is a detectable particle and the other of the first and second particles is a quencher particle. The oligopeptide linkage comprises a supramolecular recognition sequence, a protease consensus sequence, a post-translationally modifiable sequence, or a sterically hindered benzylether bond for specific interaction with the target biological marker. 
     Also described herein are nanosensors for detecting the presence of an active protein in a sample. The nanosensors comprise a central carrier particle and a first particle connected to the central carrier particle via an oligopeptide linkage that comprises a supramolecular recognition sequence, wherein the protein has specific binding to the supramolecular recognition sequence without chemical modification or enzymatic cleavage of the linkage. A second particle is also directly attached to the central carrier particle via a non-cleavable linkage (that is generally shorter than the oligopeptide linkage of the first particle). In the sensors, at least one of the first and second particles is a detectable particle and the other of the first and second particles is a quencher particle. The nanosensor is configured such that the detectable particle and quencher particle are separated by a distance that enables Förster resonance energy transfer. 
     Methods for detecting the presence of an active protein in a sample from a mammal are also described herein. The methods generally comprise contacting a biological sample from the mammal with a nanosensor described herein; exposing the nanosensor to an energy source to generate a detectable signal from the detectable particle; and detecting changes in the detectable particle signal upon contact of the nanosensor with the sample (and more specifically with active proteins, if present, in the sample) wherein the changes correspond to protein activity in the sample. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a cartoon illustration of an example of a cytokine nanosensor in accordance with an embodiment of the invention; 
         FIG. 2  is a cartoon illustration of the mechanism of action of an example of a cytokine nanosensor in accordance with an embodiment of the invention; 
         FIG. 3  is a cartoon illustration of an inverse nanosensor in accordance with an embodiment of the invention, in which the detectable particle is directly attached to the central carrier particle (e.g., via short dopamine spacer or designer polymer), while the quencher particle is tethered via a cleavable linkage; 
         FIG. 4  is a cartoon illustration of different nanosensor types that can be used in the microfluidics devices, including (A) protease sensors; (B) arginase sensors; and (C) cytokine sensors; 
         FIG. 5  is an illustration of a nanosensor using a starburst dendrimer containing gold nanoparticles in accordance with embodiments of the invention; 
         FIG. 6  is a cartoon illustration of the chemistry for attaching the nanosensors to a cellulose substrate in a microfluidics device in accordance with embodiments of the invention; 
         FIG. 7  illustrates a (A) top-down view and (B) side view of a generalized design for a microfluidics device in accordance with embodiments of the invention; 
         FIG. 8  is a flow chart of a learning algorithm for correlating data captured with the microfluidic devices; 
         FIG. 9  is a graph of the calibration results for the nanosensors for cytokine detection, showing the log [cytokine concentration] vs. integrated fluorescence intensity, with a maximal experimental error from 5 repetitions of +/−3 relative percent; 
         FIG. 10  is a graph of the MMP9, NE, MIP-1, and Granzyme B levels detected using a Synergy H1 fluorescence plate reader in the asthma and control groups from Example 4; 
         FIG. 11  is a graph of measurements of MMP8, neutrophil elastase, granzyme B and MCP-1 levels in murine BALF from Example 5 captured using a Synergy H1 fluorescence plate reader; 
         FIG. 12  is a graph of the hydrodynamic diameters of (forming) aggregates between the exosomes in BALF and the nanosensors designed for targeting CD9, CD63, and CD81. The Figure shows Hydrodynamic Diameter vs. Time (in minutes). The experiments were performed using a Nanobrook 90Plus Zeta Particle Size Analyzer (Brookhaven Instruments Corporation); 
         FIG. 13  is a graph of the plot of the observed phase angles between applied voltage and measured current as a function of frequency, collected using a CHI 650B Analyzer/Workstation with Pt net electrode (Methrohm) under the following parameters: Initial E=0.3 V, high frequency=1×105 Hz, low frequency=1 Hz, Impedance FT, Amplitude=0.005 V, quiet time: 30 s. log 10 Frequency vs. Phase Angle is shown; 
         FIG. 14  illustrates the general Configuration of IDEA valves. (A) COMSOL multiphysics simulation 2-D cross section of an IDEA actuator. (B) Depiction of the operation of an IDEA actuator. Once the switch (e.g. optodiode) is closed the force generated between the two electrodes closes the fluidic channel between them. In order to minimize the distance between the compliant electrode (top) and the non-compliant electrode (bottom), the bottom PDMS layer may be replaced by a thin layer high dielectric film. This film can be made amenable to surface modification; 
         FIG. 15  illustrates 3 valves along a channel that can be configured to create a peristaltic pump in the microfluidic device; 
         FIG. 16  is a diagram (not to scale) of a point of care device with integrated IDEAs for the detection of biomarkers in bodily fluids; 
         FIG. 17  is a graph showing (left panel) the differential expression of secreted proteins (top) vs cell lysates (bottom) for hBECS, and (right panel) the differential expression of secreted proteins in secreted proteins vs lysates for hSAECs; 
         FIG. 18  is a transmission electron microscope (TEM) image of RSV-induced SAEC microparticles, ×98,000, Arrow=100 nm vesicle; 
         FIG. 19  shows graphs of SID-SRM for each protein providing independent confirmation of differential secreted proteins; and 
         FIG. 20  shows graphs CCL20, TSLP and CCL3-L1 are selectively secreted by lower hSAECs. SID-SRM-MS for each protein by cell type from uninfected (−) or RSV infected (+) cells. 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
     Nanosensors 
     In one aspect, described herein are nanosensors for detecting cytokines, and other proteins based upon supramolecular recognition without chemical modification or enzymatic cleavage. In use, an oligopeptide tether between a central carrier particle and a detectable particle is recognized by the target protein, which binds thereto. Binding physically extends the recognition sequence linearly, increasing the distance between the detectable particle and the carrier particle, giving rise to a detectable change in the nanosensor, which is indicative of the presence of the target protein. An exemplary depiction of a nanosensor is shown in  FIG. 1 . 
     Whereas nanoplatforms for protease detection, such as those described in U.S. Pat. No. 8,969,027, incorporated by reference herein to the extent not inconsistent with the present disclosure, feature “protease consensus sequences” that undergo enzymatic cleavage, or nanoplatforms for detection of enzymatic posttranslational modification described in WO 2016/149637, incorporated by reference herein to the extent not inconsistent with the present disclosure, the particular nanosensors do not involve cutting or severing the oligopeptide between the nanoparticle and dye, or changing the chemical characteristics, but rather a physical binding of the target protein to the recognition sequence. Again, this binding leads to a change in the average distance between two particles, resulting in a characteristic change in a detectable signal for the particles used in the nanosensor, such as a fluorescence spectrum. The observable change in fluorescence (increase or decrease, depending on the chemical nature of the peptide sequences before and after binding) is a function of protein activity. The quenching effect can be enhanced by tethering a second dye to the surface of the carrier nanoparticle to facilitate FRET (Förster Resonance Energy Transfer). The general mechanism is depicted via a cartoon illustration in  FIG. 2 . It will be appreciated that unlike other sensor mechanisms, the present nanosensors are able to detect active proteins. 
     The nanosensors according to these embodiments comprise an oligopeptide, which is used as a peptide linkage between two particles. The linkage comprises a supramolecular recognition sequence for the target protein, which means that the linkage sequence has specificity (i.e., contains a selective binding site) for the target protein). Thus, it will be appreciated that the linkage sequences avoid non-specific binding motifs. Further, the oligopeptide linkage containing the supramolecular recognition sequence is preferably “non-cleavable” which means that it does not contain protease cleavage sites, and the like. The oligopeptide linkage attaches a detectable particle to a central carrier particle. In one or more embodiments, a quencher particle is also directly tethered or attached to the central carrier particle, such as through an amide bond. In other words, the phrase “directly attached” as used herein means that the quencher particle is connected directly to the surface of the central particle, or to a ligand layer on the surface of the central particle (and is not attached via an enzymatic substrate sequence or other consensus sequence). 
     Initially, the oligopeptide linkage in the nanosensor has a folded secondary structure, such as an alpha-helix and/or beta-sheet structure, so that the detectable particle is separated from the central carrier particle (and quencher particle at the carrier particle&#39;s surface) by a first distance. In the presence of the target protein, such as a cytokine, the protein binds to the supramolecular recognition sequence in the oligopeptide modifying the secondary structure of the oligopeptide sequence, such that it linearly extends or unfolds, and thus changes the distance of the second particle to the central carrier particle (and quencher particle). Accordingly, after being exposed to the target protein, the detectable particle is then separated from the central carrier particle (and quencher particle) by a second distance that is greater than the first distance in the initial nanosensor. The detectable particle generates a detectable signal that changes depending upon its proximity to the carrier particle or quencher particle, and which can be detected and correlated with activity of the target protein. 
     The central carrier particle can be a variety of particles discussed herein, with the proviso that it can be attached with two or more different particles. Preferably, the nanosensor comprises a plurality of quencher particles attached to a single central carrier particle, and a plurality of detectable particles attached to the same carrier particle via respective oligopeptide linkages. Preferably, the amount of quencher particles attached to the carrier particle is greater than the amount of detectable particles tethered to the carrier particle. In one or more embodiments, the ratio of the number of quencher particles (directly attached) to detectable particles (tethered) on each carrier particle is from about 1:1 to about 1:100, more preferably from about 1:1.5 to about 1:35, and more preferably about 1:35. In one or more embodiments, the central carrier particle is one that is capable of SET (Dipole-surface Energy Transfer), and/or participates in quenching of the detectable signal of one or both of the attached particles (and particularly the second particle). In one or more embodiments, the central carrier particle does not actively participate in the signal being detected in the assay, but is simply a carrier structure for tethering the first and second particles. Non-plasmonic particles can be used in certain embodiments. 
     The detectable particles generate a detectable signal (e.g., optical or spectroscopic), such as fluorescence or color change, which can be perceived visually or measured with an appropriate instrument. In one or more embodiments, the quencher and detectable particles are selected to show intense FRET in the pair. In one or more embodiments, the quencher and detectable particles are paired so as to enhance the SET quenching of the carrier particle. 
     The nanosensors are particularly suitable for detection methods based upon surface plasmon resonance and FRET between non-identical particles (i.e., nanoparticles or a dye and porphyrin, or two different dyes). FRET describes energy transfer between two particles. Surface plasmon resonance is used to excite the particles. A donor particle initially in its excited state, may transfer this energy to an acceptor particle in close proximity through nonradiative dipole-dipole coupling. Briefly, while the detectable particle is bound by the oligopeptide in its initial state, a first emission is observed upon excitation of the donor particle. Once the peptide binds to the supramolecular recognition sequence, FRET change is observed, and the emission spectra changes. In some instances, only the donor emission is observed. In other instances, the emission spectra simply changes (increases or decreases). In more detail, if both particles are within the so-called Förster-distance, energy transfer occurs between the two particles and a red-shift in emission is observed. During this ultrafast process, the energy of the electronically excited state or surface plasmon of the second particle is at least partially transferred to the first particle. In some embodiments, this means that a detectable signal (e.g., fluorescence, light) is actually emitted from the quencher particle. However, once the distance between the two particles is changed by the enzyme, light is emitted only from the detectable particle and a distinct blue-shift in absorption and emission can be observed. This is because the distance between both particles increases. In other embodiments, a signal may be detectable from both particles in the initial nanosensor, however, upon modification of the substrate sequence, the signal intensity from the detectable particle increases as the distance between the two particles increases. 
     In one or more embodiments, the quencher particle (directly attached to the central particle) is an acceptor and the detectable particle (tethered via the oligopeptide) is a donor. In general, excitation of the nanosensor is directed towards the particle having a higher energy state (e.g., the donor particle). Excitation of the detectable particle can preferably performed between about 400 nm and about 1500 nm, more preferably between about 500 nm to about 800 nm, and even more preferably between about 650 nm and about 800 nm. When using chromophore/luminophore particle pairs, there is also preferably an overlap between the excitation spectrum of the first chromophore/luminophore and the fluorescence or phosphorescence spectrum of the second chromophore/luminophore to permit adequate Förster energy transfer. In one embodiment, cyanine 5.5 (donor) and cyanine 7.0 (acceptor) form a very attractive FRET-pair. 
     In the assay, so-called Förster-distance, energy transfer occurs between the quencher and detectable particles and a change in absorbance and/or emission of the nanoplatform is observed. During this ultrafast process, the energy of the electronically excited state or surface plasmon of the detectable particle is at least partially transferred to the quencher particle. Excitation is preferably performed with an energy source of appropriate wavelength selected from the group consisting of a tungsten lamp, laser diode, laser, and bioluminescence (e.g., luciferase, renilla, green fluorescent protein). The changes in absorption and/or emission of the particles as the peptide binds (without cleaving or chemically modifying) the oligopeptide linkages will be observed over a time period of from about 1 second to about 120 minutes, preferably from about 1 second to about 30 minutes, and in some cases from about 30 seconds to about 10 minutes, depending upon protein activity. 
     In practice, the assay can first be calibrated for the particular nanosensor using a control sample with and without the target proteins, as described in the working examples. For storage and/or use, the nanosensors would typically be dispersed into a pharmaceutically acceptable solvent system, which could be any type of suitable diluent, excipient, vehicle or the like. As used herein, the term “pharmaceutically acceptable” means not biologically or otherwise undesirable, in that it can be administered to a subject without excessive toxicity, irritation, or allergic response, and does not cause unacceptable biological effects or interact in a deleterious manner with any of the other components of the composition in which it is contained. A pharmaceutically-acceptable carrier would naturally be selected to minimize any degradation of the nanoplatform other agents and to minimize any adverse side effects in the subject (for in vivo administration), as would be well known to one of skill in the art. Pharmaceutically-acceptable ingredients include those acceptable for veterinary use as well as human pharmaceutical use, and will depend on the route of administration. For example, compositions suitable for administration via injection are typically solutions in sterile isotonic aqueous buffer. Exemplary carriers include aqueous solutions such as normal (n.) saline (˜0.9% NaCl), phosphate buffered saline (PBS), sterile water/distilled autoclaved water (DAW), or other acceptable vehicles, and the like. 
     In one or more embodiments, the nanosensors are particularly suited for detecting cytokines. The oligopeptide linkage comprises a linear supramolecular recognition sequence (i.e., paratope) for the receptor/binding site of the cytokine of interest. In the presence of the cytokine, stretching of the tether during cytokine binding leads to a signal change (e.g., fluorescence increase) from the attached detectable particle, which can be detected. The nanosensors can measure cytokine concentrations. However, this technology can be extended to virtually any protein target of interest. That is, one advantage of the inventive nanosensors is the flexibility to adapt the underlying nanosensor structure by modifying the particles, oligopeptide linkages, and the like to suit the sensor technology available, and likewise, using a variety of sensor technologies for detecting additional targets. For example, a similar nanosensor can be prepared for detecting protease activity, similar to described in U.S. Pat. No. 8,969,027, except that a quencher particle is directly attached to the central carrier particle as described herein to enhance the detectable signal, see  FIG. 4A . Likewise, methods described herein can also be adapted for use with other nanosensors, such as those described in WO 2016/149637 for detection of enzymatic posttranslational modification, see  FIG. 4B . Exemplary supramolecular recognition sequences are listed in Table 1 below. 
                     TABLE 1                   Supramolecular Recognition Sequences for the       Detection of Protein Targets                                     Recognition Sequence(s)   SEQ ID   Accession   LOD*               NO:   No.   Moles/L                         Cytokine/Chemokine Targets                                 CCL 2   CQEQFWW   1   P13500   10-14       MCP-1 a     PYFPRGSSYQGWN   2   P13500   10-15       CCL 3   CCIQNQ   3   P10147   10-15       CCL 4   AWYQPQFE   4   P13236   10-14       CCL 21   EQQKRN   5   O00585   10-15       CXCL 2   CNHGKFYC   6   P19875   10-14       CXCL 5   NIYCNIAY   7   P42830   10-13       CXCL 8   KAYRWEFI   8   P10145   10-16       (IL-8)                       CXCL 9   IQNSGAPCH   9   Q07325   10-15       HSP 27   WQEAKNANQM   10   Q5S1U1   10-15       HSP 70   RHQKTYSF   11   PODMV8   10-15       HSP 90   XLPPHWAGAL   12   P02829   10-15       MIF    XLPPHWAFAL   13   P14174   10-15       Calprotectin   LTELEKALNSIIDVYHKYSLIKGNFHAV   14   S100A9   10-14       CCL20 b     GESMNFSDVFDSSEDYFVSVNTSYYSVDSE   15   P78556   10-15           GTQWWVVCQQFG   16               GCSF c     PGHWSDWSPS   17   P09919   10-15       IL-6   YFPEPVTVSGAGTFPAVLGSGQPPGKGL   18   P05231   10-16           TAVYYCANRAGWGMGDYWGQGTQVT   19                   TASNYGAGYSTNDRHS   20                   NRPAQAWMLG   21               IL-13   AVYYCQQNNEDPRTFGGGTK   22   P35225   10-15           AGDGYYPYAMDNW   23                   GWLPFGFILISAG   24                   YQQKPGQPPKL   25                   SVNWIRQPPGKALEWLAMIWGDGKIVYNS   26                   WLPFGFILIS   27               IL1RL1 d     TYYCQQWSGYPYTF   28   P14778   10-15       MIP-1 e     SHFPYSQYQFWKN   29   Q9BPZ7   10-15       OSTF1 f     DMSDTNWWKGTSKGRTGLIPSNYVAEQA   30   Q92882   10-15           ESIDNPL                   TIMP-1 g     IAGKLQSAGSALWTDQL   31   P01033   10-12       TSLP h     SSPKHVRFSWHQDAVTVTC   32   Q960D9   10-14           AKCCPCQQWW   33                                 Peptide Aptamers-Exosome surface markers                                 CD-9 i     VQEFYKDTYNKLKTK   34   P21926   10-14       CD-63 i     LNNHTASILNRMQANF   35   P08962   10-14       CD-81 i     VGIYILIAVGAVMMFVGFK   36   P60033   10-15                         Exosome content analysis-markers of lung inflammation                                 O00571 j     NERNINITKDLLDLLVAH   37   O00571   10-14       P05187 k     DINWVKQRPGQGLEWI   38   P05187   10-15       P54136 l     VLLQGKNPDITKAWKL   39   P54136   10-15       Q5T4S7 m     NLSRSRWFDFPFTREE   40   Q5T4S7   10-14                 a Monocyte Chemoattractant Protein-1;         b Chemokine (C-C motif) ligand 20 (CCL20) or liver activation regulated chemokine (LARC) or Macrophage Inflammatory Protein-3 (MIP3A);         c Granulocyte colony-stimulating factor;         d Interleukin-l-receptor-like type 1;         e Macrophage Inflammatory Protein;         f Osteoclast Stimulating Factor-1;         g Metalloproteinase Inhibitor 1;         h Thymic stromal lymphopoietin;         i CD: Cluster of Differentiation;         j ATP-dependent RNA helicase DDX3X (from human bronchial airway epithelial cells);         k Alkaline phosphatase, placental type, phosphatase PPB1;         l Arginine-tRNA ligase, cytoplasmic;         m E3 ubiquitin-protein ligase UBR4 (small airway epithelial cells);       *Estimated limit of detection (LOD).            
The supramolecular recognition sequences can include one or more spacer residues on the N- and/or C-terminal ends. For example, between 1 and 10 amino acids (any amino acids, naturally and non-naturally, L- and D-, or combinations thereof) can be used at one or both ends as spacers. Examples include N-terminal sequences such as GAG- and C-terminal sequences such as -AG.
 
     Any other linear peptide sequence of suitable length (e.g., at least 10 amino acid residues) can be used for the supramolecular recognition sequences, with the exception of sequences featuring consensus motifs. If synthesized on a peptide synthesizer, peptide sequences up to about 25 amino acid residues can be used, whereas sequence synthesized in an organism (e.g.,  E. coli ) can be up to about 300 amino acid residues in length. Any designed sequence should to be checked for the presence of cleavage sequences, utilizing a data bank, such as MEROPS. 
     As noted, peptide-aptamers for targeting CD9, CD63, and CD81, which are generally accepted surface markers of exosomes have also been developed. They are capable of binding to the exosomes and permit their isolation directly from collected biospecimens using the nanosensors without prior (ultra)centrifugation. The combined use of CD9, CD63, and CD81 will ensure that virtually all exosomes occurring from the sample, such as from airway cells, will be trapped. After treatment with a lysis buffer, the cargo of the captured exosomes can then be analyzed. Analysis of exosomes presents another existing aspect of the technology. Exosomes occurring from small airway epithelial cells and bronchial airway epithelial cells differ significantly in their proteasomes (including the tetraspanin content (CD9, CD 63, CD81) in their outer membranes. 
     Enzyme consensus sequences that can also be used in nanosensors in combination with one or more above include those in Table 2 below, where the cleavage point is indicated by the 
                                 TABLE 2                Enzyme   Consensus Sequence   SEQ ID NO:   Accession No.                  ADAM 17   LAQA-VVSS   41   P78536               ADAM 33   GSQH-IRAE   42   Q9BZ11               Cathepsin B   SLLKSR-MVPNFN   43   P07858               Cathepsin D   GDSG-LGRA   44   P07339               Cathepsin E   EVAL-VALK   45   P14091               Cathepsin K   LGLE-GANL   46   P43235               Cathepsin L   AALG-SAPG   47   P07711               Cathepsin S   SLLIFR-SWANFN   48   P25774               Granzyme B   VEPN-SLEE   49   P10144               NE   GEPL-SLLP   50   P08246               MMP 1   IPVS-LRSG   51   P03956               MMP 2   IPVS-LRSG   51   P08253               MMP 3   RPFS-MIMG   52   P08254               MMP 7   VPLS-LTMG   53   P09237               MMP 8   GPSG-LRGA   54   P22894               MMP 9   VPLS-LYSG   55   P14780               MMP 11   GAAN-LVRG   56   P24347               MMP 12   GVPLS-LTMG   57   P34960               MMP 13   PQGLA-GQRGIV   58   P33435               MMP 14   GPAG-LRLA   59   P50281               ALK   RDIYAAPFFRK   60   Q9UM73               AURKB   AMERRRTSAARRSY   61   Q96GD4               CDK2   KARAAVSPQKRKA   62   P24941               PKD2   RARKRRLSAPPLASGD   63   Q504Y2               MAPK1   AKAGPPLSPRPPHVH   64   P28482               JAK2   DLFIPDNYLKMKPAP   65   060674               PLK1   AELDPEDSMDMDMAP   66   P53350               PLK3   EDEAEELSDEDEELK   67   Q9H4B4               ERK1/MAPK3   AAGPAPLSPVPPVVH   68   P27361               JunK2/MAPK9   DASRPPPLSPLPSPRA   69   P45984               ARG I/II   GRRRRRRRG   70   P05089 (ARG1)                   P78540 (ARG2)                    
In a further preferred embodiment of the current invention, inflammatory biological markers can be detected along with detection of specific viral, bacterial, or mold infections. For example, nanosensors could be prepared using a peptide aptamer against Capsid B (AISGSGGSTYYANSVLG (SEQ ID NO:71), recognition sequence for detecting  Haemophilus influenzae  B, or recognition sequences for  Haemophilus influenzae  NT (TNLGILHSMVARAVGNNTQG (SEQ ID NO:72)), or  Moraxella catarrhalis  (GIITYALSGGEIKILAG (SEQ ID NO:73)). Likewise, nanosensors for viral infections can be prepared using protease consensus sequences for HIV detection (SAVL-LEAT (SEQ ID NO:74), or SQNY-PIVQ (SEQ ID NO:75)).
 
     It will be appreciated that each of the foregoing sensors described above can be designed in an alternative configuration where the detectable particle is attached to the central carrier particle in a “permanent” manner (e.g., via non-cleavable peptide sequence), whereas the quencher particle is attached via a supramolecular recognition sequence, a protease consensus sequence, a post-translationally modifiable sequence, or a sterically hindered benzylether bond that interacts with the target biomarker. In such embodiments, while the detectable particle remains relatively stationary and affixed to the carrier particle, the quencher particle is instead either cleaved or moved away from the detectable particle and carrier particle, to effect the change in distance between the particles, as described above. As noted, the increase in distance between the quencher particle and the detectable particle (from cleavage or elongation of the quencher particle tether) results in a detectable change in the signal from the nanosensor. 
     Alternative embodiments of the invention concern “inverse” nanosensors from protease sensors discussed here, and illustrated in  FIG. 3 . When using a microfluidic-based device, such as paper microfluidic devices, the detectable particle will generally be cleaved off when enzymatic activity is detected. However, it would be desirable if the detectable signal occurring from this particle would occur from a constrained site on the test strip. Therefore, we have constructed the “inverse nanoplatforms for protease detection”, in which the detectable particle is linked to the carrier particle by a short (e.g., 1.4-1.5 nm) peptide sequence. At this distance from the carrier particle (e.g., in the case of Fe/Fe 3 O 4  nanoparticles: Fe core diameter 13+/−0.5 nm; shell diameter 2.0+/−1 nm, dopamine layer˜1 nm) their plasmonic scattering is highest and, therefore, the fluorescence of the detectable particle is enhanced. Upon cleavage, the fluorescence decreases, not increases. 
     Another alternative embodiment involves a nanosensor to detect Hydrogen Sulfide (H 2 S). H 2 S has been recently established as powerful biomarker for chronic respiratory diseases, based on significant metabolic differences between healthy human subjects and patients with asthma or chronic obstructive pulmonary disease (COPD). In an exemplary embodiment, the nanosensor is utilized for measuring the H 2 S concentration in biospecimens. The design of the nanosensor is based on the fact that the hydrogen sulfide anion (HS − ) is the predominant species under physiological conditions (approx. 80% at 37° C. and pH=7.4). HS −  is a potent nucleophile that readily reacts with metal centers (for instance in coenzymes). The distinctly higher nucleophilicity of HS −  will be utilized to differentiate this biological marker from cysteine, methionine, glutathione and cysteine-containing peptides and proteins. The approach is similar to the protease sensors discussed above. A detectable particle is tethered to a central carrier particle via a cleavable sterically hindered benzyl ether bond (i.e., with adjacent carbons substituted with methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, etc.). Nucleophilic cleavage of the bond releases the detectable particle, and the associated change in the nanosensor can be detected. 
     It will be appreciated that assays according to the invention can utilize a combination of two or more of the various sensors discussed above. Importantly, nanosensors utilized in accordance with the invention will be designed to include a supramolecular recognition sequence, a protease consensus sequence, a post-translationally modifiable sequence, or a sterically hindered benzylether bond that gives rise to a specific interaction with a biological marker. As used herein, references to “specific interactions” (and the like) is intended to differentiate the inventive sensors from non-specific binding or reactions between molecules, and means that the set of specific target analytes for which the oligopeptide sequence can interact is limited, and in some cases even exclusive, such that neither binding nor enzymatic cleavage occurs at an appreciable rate with any other molecule. The mechanism for these preferred configurations of nanosensors is illustrated in  FIG. 4 . 
     Particles for Nanosensors 
     A number of different types of particles can be used to form the nanosensors, depending upon the type of sensor used to measure the target&#39;s activity, as discussed in more detail below. Preferably, the excitation and emission spectral maxima of the particles are between 650 and 800 nm. Preferred particles for use in the nanosensors are selected from the group consisting of nanoparticles, chromophores/luminophores, quantum dots, viologens, and combinations thereof. 
     1. Nanoparticles 
     The term “nanoparticle” as used herein refers to nanocrystalline particles that can optionally be surrounded by a metal and/or nonmetal nanolayer shell. Such nanoparticles can be metal nanoparticles: metal, metal alloy, metal oxide, or core/shell metal nanoparticles (e.g. Fe 2 O 3 , Fe 3 O 4 ). Metal nanoparticles can alternatively be surrounded by a second shell of silica, as described in U.S. Pat. No. 8,877,951, incorporated by reference herein to the extent not inconsistent with the present disclosure. Depending on the chemical composition of the nanoparticles and their actual size, the optimal distance between plasmonic core and shell can be determined experimentally. 
     Suitable nanoparticles preferably have a diameter of from about 1 nm to about 100 nm, more preferably from about 10 nm to about 50 nm, and even more preferably from about 5 nm to about 20 nm. Metal nanoparticles can comprise any type of metal (including elemental metal) or metal alloy. Preferably, the metal or metal alloy nanoparticles comprise a metal selected from the group consisting of gold (Au), silver (Ag), copper (Cu), nickel (Ni), palladium (Pd), platinum (Pt), cobalt (Co), rhodium (Rh), iridium (Ir), iron (Fe), ruthenium (Ru), osmium (Os), manganese (Mn), rhenium (Re), scandium (Sc), titanium (Ti), vanadium (V), chromium (Cr), zinc (Zn), yttrium (Y), zirconium (Zr), niobium (Nb), molybdenum (Mo), technetium (Tc), cadmium (Cd), lanthanum (La), lutetium (Lu), hafnium (Hf), tantalum (Ta), tungsten (W), actinium (Ac), lawrencium (Lr), rutherfordium (Rf), dubnium (Db), seaborgium (Sg), bohrium (Bh), Hassium (Hs), meitnerium (Mt), darmstadtium (Ds), roentgenium (Rg), ununbium (Uub), selenium (Se), and the oxides (e.g., FeO, Fe 3 O 4 , Fe 2 O 3 , Fe x O y  (non-stoichiometric iron oxide), CuO, NiO, Ag 2 O, Mn 2 O 3 ), hydroxides, sulfides, selenides, and tellurides of the foregoing, and combinations thereof. 
     In some embodiments, metal nanoparticles will be bimagnetic and comprise a metal or metal alloy core and a metal shell. Core/shell metal nanoparticles preferably comprise a metal or metal alloy core and a metal shell. Preferred cores are selected from the group consisting of Au, Ag, Cu, Co, Fe, and Pt. Even more preferably, the metal nanoparticles feature a strongly paramagnetic Fe core. Preferred shells are selected from the group consisting of Au, Ag, Cu, Co, Fe, Pt, the metal oxides (e.g., FeO, Fe 3 O 4 , Fe 2 O 3 , Fe x O y  (non-stoichiometric iron oxide), CuO, Cu 2 O, NiO, Ag 2 O, Mn 2 O 3 ) thereof, and combinations thereof. Particularly preferred metal core/shell combinations are selected from the group consisting of Fe/Au, Fe(0)/Fe 3 O 4 , and Au/Fe 2 O 3 . A particularly preferred metal nanoparticle is a superparamagnetic Fe/Fe 3 O 4  core shell nanoparticle. More preferably, the nanoparticles feature an iron(0) core, which is more magnetic than iron oxide, based upon coercivity. This means that smaller nanoparticles can be used (diameter less than about 10 nm), which have the same or greater magneticity than larger iron oxide nanoparticles (diameter of about 200 nm). 
     In one or more embodiments, the core of the metal nanoparticle preferably has a diameter of from about 2 nm to about 100 nm, more preferably from about 3 nm to about 18 nm and more preferably from about 5 nm to about 9 nm. The metal shell of the core/shell nanoparticle preferably has a thickness of from about 1 nm to about 10 nm, and more preferably from about 1 nm to about 2 nm. The nanoparticles preferably have a Brunauer-Emmett-Teller (BET) multipoint surface area of from about 20 m 2 /g to about 500 m 2 /g, more preferably from about 50 m 2 /g to about 350 m 2 /g, and even more preferably from about 60 m 2 /g to about 80 m 2 /g. The nanoparticles preferably have a Barret-Joyner-Halenda (BJH) adsorption cumulative surface area of pores having a width between 17.000 Å and 3000.000 Å of from about 20 m 2 /g to about 500 m 2 /g, and more preferably from about 50 m 2 /g to about 150 m 2 /g. The nanoparticles also preferably have a BJH desorption cumulative surface area of pores having a width between 17.000 Å and 3000.000 Å of from about 50 m 2 /g to about 500 m 2 /g, and more preferably from about 50 m 2 /g to about 150 m 2 /g. The nanoparticle population is preferably substantially monodisperse, with a very narrow size/mass size distribution. More preferably, the nanoparticle population has a polydispersity index of from about 1.2 to about 1.05. It is particularly preferred that the nanoparticles used in the inventive nanoplatforms are discrete particles. That is, clustering of nanocrystals (i.e., nanocrystalline particles) is preferably avoided. 
     The nanoparticles can be stabilized or non-stabilized. Stabilized nanoparticles preferably comprise an organic monolayer surrounding the nanoparticle core. The term “stabilized” as used herein means the use of a ligand shell or monolayer to coat, protect (e.g., from bio-corrosion), or impart properties (e.g., water solubility) to, the nanoparticle. The monolayer can be comprised of several of the same ligands (i.e., homoligand) or of mixed ligands. Various techniques for attaching ligands to the surface of various nanoparticles are known in the art. For example, nanoparticles may be mixed in a solution containing the ligands to promote the coating of the nanoparticle. Alternatively, coatings may be applied to nanoparticles by exposing the nanoparticles to a vapor phase of the coating material such that the coating attaches to or bonds with the nanoparticle. Preferably, the ligands attach to the nanoparticle through covalent bonding. The number of ligands required to form a monolayer will be dependent upon the size of the nanoparticle. 
     The ligands comprise functional groups that are attracted to the nanoparticle&#39;s metal surface. Preferably, the ligands comprise at least one group selected from the group consisting of thiols, alcohols, nitro compounds, phosphines, phosphine oxides, resorcinarenes, selenides, phosphinic acids, phosphonicacids, sulfonic acids, sulfonates, carboxylic acids, disulfides, peroxides, amines, nitriles, isonitriles, thionitiles, oxynitriles, oxysilanes, alkanes, alkenes, alkynes, aromatic compounds, and seleno moieties. Preferred organic monolayers are selected from the group consisting of alkanethiolate monolayers, aminoalkylthiolate monolayers, alkylthiolsulfate monolayers, and organic phenols (e.g., dopamine and derivatives thereof). The thickness of the organic monolayer is preferably less than about 10 nm, and more preferably less than about 5 nm. Particularly preferred stabilized nanoparticles are selected from the group consisting of trioctyl-phosphinoxide-stablized nanoparticles, amine-stabilized nanoparticles, carboxylic-acid-stabilized nanoparticles, phosphine-stabilized nanoparticles, thiol-stabilized nanoparticles, aminoalkylthiol-stabilized nanoparticles, and organic phenol-stabilized nanoparticles. 
     For attachment to the oligopeptide linkages, the preferred ligands will preferably readily react with the thiol group of the terminal cysteine of the oligopeptide linkage. The nanoparticle surface will preferably be essentially completely covered with ligands. That is, at least about 70%, preferably at least about 90%, and more preferably about 100% of the surface of the nanoparticle will have attached ligands. The number of ligands required to form a monolayer will be dependent upon the size of the nanoparticle (and monolayer), and can be calculated using molecular modeling or ligand modeling methods. 
     Various techniques for attaching ligands to the surface of various nanoparticles are known in the art. For example, nanoparticles may be mixed in a solution containing the ligands to promote the coating of the nanoparticle surface. Alternatively, coatings may be applied to nanoparticles by exposing the nanoparticles to a vapor phase of the coating material such that the coating attaches to or bonds with the nanoparticle. Preferably, the ligands attach to the nanoparticle through covalent bonding. 
     Nanoparticles can also be non-metal: non-metal oxide (e.g. SiO 2 ), polysilicone, polysilazane, or polysiloxazane, starburst dendrimers, or polymer latex nanoparticles. For example, in one or more embodiments, it is possible to replace the carrier nanoparticle with a starburst dendrimer or starburst dendrimer containing gold nanoparticles, as illustrated in  FIG. 5 . Poly-(amidoamine) (PAMAM) dendrimers have defined three-dimensional shape, size, topology, and peripheral functional groups. What makes PAMAM dendrimers different from other polymers is that PAMAM dendrimers are pure macromolecules, with precise molecular weight for each generation (starburst polymers). Dendrimers can be purchased according to desired specifications. Therefore, it is not necessary to synthesize inorganic nanoparticles. The approach is otherwise the same as described herein. One advantage is that the shelf life for dendrimer-based nanosensors is greater than 5 years. Further, PAMAM dendrimer stick to cellulose, and can be printed directly onto paper. This would facilitate mass fabrication of paper microfluidic devices by applying inexpensive desk jet printing technology, as described herein. 
     2. Chromophores/Luminophores 
     Chromophore/luminophore particles suitable for use in the inventive assays include any organic or inorganic dyes, fluorophores, phosphophores, light absorbing nanoparticles (e.g., Au, Ag, Pt, Pd), combinations thereof, or the metalated complexes thereof. Preferably, the chromophore/luminophore particles have a size (maximum surface-to-surface dimension, i.e., diameter) of less than about 100 nm. 
     Suitable organic dyes are selected from the group consisting of coumarins, pyrene, cyanines, benzenes, N-methylcarbazole, erythrosin B, N-acetyl-L-tryptophanamide, 2,5-diphenyloxazole, rubrene, and N-(3-sulfopropyl)acridinium. Specific examples of preferred coumarins include 7-aminocoumarin, 7-dialkylamino coumarin, and coumarin 153. Examples of preferred benzenes include 1,4-bis(5-phenyloxazol-2-yl)benzene and 1,4-diphenylbenzene. Examples of preferred cyanines include oxacyanines, thiacyanines, indocyanins, merocyanines, and carbocyanines. Other exemplary cyanines include ECL Plus, ECF, C3-Oxacyanine, C3-Thiacyanine Dye (EtOH), C3-Thiacyanine Dye (PrOH), C5-Indocyanine, C5-Oxacyanine, C5-Thiacyanine, C7-Indocyanine, C7-Oxacyanine, CypHer5, Dye-33, cyanines (Cy7, Cy7.5, Cy5.0, Cy5.5, Cy3Cy5 ET, Cy3B, Cy3.0, Cy3.5, Cy2), CBQCA, NIR1, NIR2, NIR3, NIR4, NIR820, SNIR1, SNIR2, SNIR4, Merocyanine 540, Pinacyanol-Iodide, 1,1-Diethyl-4,4-carbocyanine iodide, Stains All, Dye-1041, or Dye-304. 
     Cyanine dyes are particularly preferred organic dyes for use in the nanoplatforms. The fluorescent cyanine dye is tethered to the nanoparticle and experiences rapid fluorescence quenching by the plasmon of the Fe(0)-core. This is observed as long as the tether is smaller than the Förster-radius of the cyanine dye (5-6 nm for Cy3.0 and Cy3.5, 6-7 nm for Cy5.0 and Cy5.5, and approx. 7 nm for Cy7 and Cy7.5). The maximal length of the tether, consisting of the ligand (˜2.84 nm) and not more than 12 amino acid residues in the cleavage sequences (up to 4 nm) indicates that shorter cleavage sequences (uPA and MMP&#39;s) are suitable for use with Cy3.x and Cy5.x dyes, whereas the cathepsins are preferably linked to Cy5.x and Cy.7.x dyes to permit optimal quenching of the tethered cyanine dyes. For all of the cyanines, their emission maxima are red-shifted with respect to the autofluorescence of human urine. Multiple cyanines can be linked to a single nanoparticle to create oligoplexing nanoplatforms, to measure the activity of up to four enzymes simultaneously. All four dyes in the UVA or blue region of the electromagnetic spectrum can be excited simultaneously, or each dye can be excited individually. All cyanine dyes have an excitation maximum, which is blueshifted by 20-25 nm with respect to their emission maximum (typical for fluorescent singlet states). Exemplary emission spectra of: NS-Cy3.0 (λex=538, λem=560), NS-Cy5.5 (λex=639, λem=660), NS-Cy7.0 (λex=740, λem=760) and NS-Cy7.5 (λex=808, λem=830). 
     Suitable inorganic dyes are selected from the group consisting of metalated and non-metalated porphyrins, phthalocyanines, chlorins (e.g., chlorophyll A and B), and metalated chromophores. Preferred porphyrins are selected from the group consisting of tetra carboxy-phenyl-porphyrin (TCPP) and Zn-TCPP. Preferred metalated chromophores are selected from the group consisting of ruthenium polypyridyl complexes, osmium polypyridyl complexes, rhodium polypyridyl complexes, 3-(1-methylbenzoimidazol-2-yl)-7-(diethylamino)-coumarin complexes of iridium(III), and 3-(benzothiazol-2-yl)-7-(diethylamino)-coumarin complexes with iridium(III). 
     Suitable fluorophores and phosphophores are selected from the group consisting of phosphorescent dyes, fluoresceines, rhodamines (e.g., rhodamine B, rhodamine 6G), and anthracenes (e.g., 9-cyanoanthracene, 9,10-diphenylanthracene, 1-Chloro-9,10-bis(phenyl-ethynyl)anthracene). 
     3. Quantum Dots 
     A quantum dot is a semiconductor composed of atoms from groups II-VI or III-V elements of the periodic table (e.g., CdSe, CdTe, InP). The optical properties of quantum dots can be manipulated by synthesizing a (usually stabilizing) shell. Such quantum dots are known as core-shell quantum dots (e.g., CdSe/ZnS, InP/ZnS, InP/CdSe). Quantum dots of the same material, but with different sizes, can emit light of different colors. Their brightness is attributed to the quantization of energy levels due to confinement of an electron in all three spatial dimensions. In a bulk semiconductor, an electron-hole pair is bound within the Bohr exciton radius, which is characteristic for each type of semiconductor. A quantum dot is smaller than the Bohr exciton radius, which causes the appearance of discrete energy levels. The band gap, ΔE, between the valance and conduction band of the semiconductor is a function of the nanocrystal&#39;s size and shape. Quantum dots feature slightly lower luminescence quantum yields than traditional organic fluorophores but they have much larger absorption cross-sections and very low rates of photobleaching. Molar extinction coefficients of quantum dots are about 10 5 -10 6  M −1  cm −1 , which is 10-100 times larger than dyes. 
     Core/shell quantum dots have higher band gap shells around their lower band gap cores, which emit light without any absorption by the shell. The shell passivates surface nonradiative emission from the core thereby enhancing the photoluminescence quantum yield and preventing natural degradation. The shell of type I quantum dots (e.g. CdSe/ZnS) has a higher energy conduction band and a lower energy valance band than that of the core, resulting in confinement of both electron and hole in the core. The conduction and valance bands of the shell of type II quantum dots (e.g., CdTe/CdSe, CdSe/ZnTe) are either both lower or both higher in energy than those of the core. Thus, the motions of the electron and the hole are restricted to one dimension. Radiative recombination of the exciton at the core-shell interface gives rise to the type-II emission. Type II quantum dots behave as indirect semiconductors near band edges and therefore, have an absorption tail into the red and near infrared. Alloyed semiconductor quantum dots (CdSeTe) can also be used, although types I and II are most preferred. The alloy composition and internal structure, which can be varied, permits tuning the optical properties without changing the particles&#39; size. These quantum dots can be used to develop near infrared fluorescent probes for in vivo biological assays as they can emit up to 850 nm. 
     Particularly preferred quantum dots are selected from the group consisting of CdSe/ZnS core/shell quantum dots, CdTe/CdSe core/shell quantum dots, CdSe/ZnTe core/shell quantum dots, and alloyed semiconductor quantum dots (e.g., CdSeTe). The quantum dots are preferably small enough to be discharged via the renal pathway when used in vivo. More preferably, the quantum dots are less than about 10 nm in diameter, even more preferably from about 2 nm to about 5.5 nm in diameter, and most preferably from about 1.5 nm to about 4.5 nm in diameter. If different color emission is needed for creating multiple sensors (multiplex detection), this can be achieved by changing the size of the quantum dot core yielding different emission wavelengths. The quantum dots can be stabilized or unstabilized as discussed above regarding nanoparticles. Preferred ligands for stabilizing quantum dots are resorcinarenes. 
     Methods 
     Methods for noninvasive detection and quantification of various biological markers are also described herein. These methods utilize nanosensors described herein and can be carried out in health care facilities as an integral part of point of care resources, at home or in the field for assessing biological markers indicative of acute injury as well as chronic conditions. 
     Such biological marker-based diagnostics could have numerous applications in precision medicine, particularly for airway diseases, where the availability of point of care devices could lead to the development of personalized treatment strategies for individual patients based on the assessment of the temporal and spatial distributions of inflammatory markers of the airways. Because protein signatures in airways are not well reflected in circulating blood, the initial diagnostic would involve, in some aspects, sampling fluids from the airways using nasopharyngeal washes (in children), induced sputum, bronchoalveolar lavage, exhaled breath condensates, and the like. Biological samples for other conditions include other biological specimens and fluids, such as blood, urine, saliva, tears, sputum, bronchoalveolar lavage fluid, breath condensate, feces, rectal fluid, vaginal fluid, and the like. In one aspect, a biological sample is collected from a subject and prepared for analysis. The sample can be collected and prepared manually, which includes, for example, manual pipetting of sample, manual protein spot cutting, manual biopsy collection, manual blood draw, and manual microfluidic chip loading. Alternatively, and automated process can be used, which includes, for example, use of automated liquid handlers, automated protein spot cutters, automated biopsy collection, automated blood draws, and automated microfluidics chip loading. It will be appreciated that the biological sample contains secreted proteins, micro-vesicle proteins, exosomes and components thereof, including but not limited to RNA and DNA, enzymes, and the like, which can be used as biological markers indicative of the health status of the subject. 
     Once the biological sample has been collected, the same can be subjected to additional processing for analysis. For example, manual processing approaches can be used including, but is not limited to, manual transfer, manual mixing, and manual phased extraction of samples and chemical components. It will also be appreciated that automated processing approaches can also be used, including, but is not limited to, the use of automated liquid handling devices for sample and chemical component transfer, mixing, and phased extraction. In a further preferred embodiment of the current invention, the automated processing step utilizes an automated microfluidics device for sample and chemical component transfer, mixing, and phased extraction. In general, the biological sample will be a liquid biospecimen. In one or more embodiments, the sample is mixed with a pharmaceutically acceptable buffer solution to yield a liquid biospecimen for analysis. In one or more embodiments, the sample (regardless of whether initially in liquid form) is mixed with a solution containing metal cofactors or other components to preserve enzymatic and protein activity in the sample during the processing and analysis. 
     For micro-vesicle proteins just as exosomes, additional sample processing steps may be required for target detection. In a preferred embodiment of the current invention, exosome surface recognition elements are used to isolate exosomes from the other biological material sample content. The surface recognition elements include, but are not limited to, exosome specific protein markers including tetraspanins (e.g., CD9, CD37, CD53, CD63, CD81 and CD82), endosome associated proteins (e.g., small Rab family GTPases, annexins and flotillin), proteins involved in exosome biogenesis (e.g., Alix, Tsg101 and ESCRT complex), heat shock proteins (Hsp70, Hsp90) and epithelial cell adhesion molecules (EpCam). Magnetic capture methodologies are used to capture the exosomes using fixed attachment of the corresponding surface recognition binding sequence. For example, magnetic nanoparticle-based nanosensors (i.e., magnetic capture nanosensors) can initially be used for isolation and capture of exosomes with supramolecular recognition binding sequences in the sensors that recognize and bind to exosome surface proteins. The nanosensors (containing bound exosomes) can then be filtered, for example, using magnets to remove the nanosensors from surrounding materials. Once the exosomes have been magnetically captured onto a plate, chip, or other collection vehicle, the exosomes are lysed to expose their cargo for further processing, profiling, and target detection. In an embodiment of the current invention, exosome lysis utilizes a plurality of methods such as, but not limited to heat, electromagnetic, acoustic, chemical, photonic, or combination thereof to achieve lysis. It will be appreciated that isolation and lysing of the exosomes may be carried out on the same microfluidics device, for example, in a microfluidics channel capture region “upstream” of the detection region. It may also be carried out in a separate microfluidics device, before subsequent introduction of the lysed exosomes into the analysis device. Further, conventional isolation and capture techniques can be used before the exosomes are assessing using the technology. 
     It is also noted that surface proteins can be used as biomarkers related to cancer diagnosis. Thus, it is not always necessary to lyse the captured exosomes, as the surface biomarkers themselves can be used for analysis of the sample. 
     It will be appreciated that the foregoing techniques related to preparing the exosomes for analysis has a distinct advantage over existing exosome processing techniques. Namely, current techniques rely on high-speed centrifugation and often damage the exosomes or significantly increases their fragility (which hampers additional manipulation or analysis). The inventive approach is, by contrast, relatively gentle, and preserves the functionality of the exosomes (and their contents). 
     Once the biological markers are prepared, the method proceeds to detection. In one or more embodiments, nanosensors according to embodiments of the invention are used for detection and identification of biological markers in the sample. The nanosensors are designed and/selected based upon the desired target marker selected for detection. For example, the nanosensors can be used to diagnose lower respiratory tract infections by detecting markers associated with infected lower airway epithelial cell infection. These markers include CCL20, TSLP, and CCL3-L1. As noted herein, exosome contents can be used to determine whether the exosomes originated from the upper or lower airway, and further assist in localization of where the infection or other condition may originate from in the subject&#39;s body. The nanosensors can also be used for environmental risk assessment in patients with chronic lung disease. Exposure to air pollutants, ozone, particulates, acetaldehydes, acreleine, formaldehyde, tobacco smoke and other compounds triggers inflammation of the respiratory tract. Detection of markers such as cytokines, proteases, and/or kinases can be used to identify the stage at which lower respiratory tract inflammation is manifest, allowing for personalized environmental assessment. The nanosensors can also be used for measurement of lower respiratory tract inflammation in the real-time management of inflammation in asthma. Details regarding biological markers and understanding of protein expression patterns associated with severe asthma are described in U.S. Pat. No. 8,053,199, incorporated by references herein. Currently anti-inflammatory (corticosteroids, IL-13 antibodies and others) are given and monitored on the basis of symptoms and exacerbations. By testing for lower airway markers such as cytokines, proteases, and/or kinases patients and caregivers can track inflammation in real time and adjust treatments accordingly. Similarly, the nanosensors can be used for measurement of lower airway remodeling in severe asthma and chronic obstructive lung disease (COPD). Remodeling refers to the process of fibrosis of the respiratory tract, a process linked to progressive decline in lung function in a subset of patients with severe asthma and COPD. There is no treatment or diagnostic currently available. New therapies directed towards epigenetic remodeling are currently being developed. Our method will enable the development and approval of remodeling inhibitors for clinical use by detecting and measuring the presence of fibronectin, IL6, or vimentin, as indicative of progressive airway remodeling. 
     Opportunistic infections are also a significant complication in patients being treated for cancer, immunosuppressed through treatment of rheumatoid arthritis or inflammatory bowel disease, or those with HIV. Pneumocystis pneumonia (PCP) is the most common infection of HIV patients, and can only be diagnosed currently by invasive bronchoscopy. Invasive aspergillosis is also an opportunistic lung infection occurring in patients undergoing chemotherapy for leukemia. The nanosensors can be used to indicate the presence of distinct host response proteins when the fungus invades the airway in patients immunosuppressed from their leukemia treatment. 
     The nanosensors can also be used for monitoring for transplant rejections or host versus graft disease in lung transplants. Lung transplant patients are treated with intensive immunosuppressive therapy and their physicians treat a fine line between too much immunosuppression (get opportunistic infections), or too little, where they would reject the organ. If a transplant patient could monitor their immune profiles in a real time basis, this would make management of the transplant much easier. It will also be appreciated that the nanosensors can be used for monitoring for response to lung cancer treatment. Mobile biosensing would detect cancer signatures, such as cytokines, proteases, and/or kinases (e.g., MMPs, EMT, etc.), in the airway or circulating in the blood. This would include free proteins and those contained within microparticles (exosomes). 
     In conjunction with protein sample collection, processing, profiling, and detection, embodiments described herein can also be utilized in conjunction with traditional PCR/RT-PCR, real-time quantitative PCR/RT-PCR, and isothermal PCR/RT-PCR methodologies to assess bacterial, viral, and mold infections that are associated with increased or decrease protein level expression. 
     Thus, assays according to the invention should not only be considered as a stand-alone technology, but can be used in conjunction with traditional approaches, especially in risk groups that have been pre-identified as being at-risk by genetic testing. 
     In general, the detection involves contacting the prepared sample with the nanosensor (and generally a plurality of nanosensors) to create a reaction mixture. The nanosensors can then be probed or excited using the appropriate energy source. The wavelength used will depend upon the particles used in the nanosensors. The changes in absorption and/or emission of the particles are then detected over a period of time as the target biomarker interacts with the nanosensors (e.g., such as through binding and extension of the recognition sequence). 
     Devices 
     Embodiments described herein also rely on nanosensors integrated with microfluidic and smart device platforms, which in turn, can be read by a simple-but-robust fluorescence or optical reader. “Microfluidic” refers to techniques manipulating, controlling, and/or analyzing small volumes of (fluid) samples, generally ranging from microliters (10 −6 ) to picoliters (10 −12 ). In one aspect, microfluidic technology is employed to introduce rapid, high-throughput sample collection, sample processing, sample profiling and target detection. In a further preferred embodiment, the microfluidic device will interface with a mobile computing device such as, but not limited to, a smart phone or smart tablet. Mobile computing devices including tablets, smart phones, hand held computers, laptops, etc. that are capable of optically scanning a sample and transmitting the information to other computing devices. This integrated platform will revolutionize the current “traditional” protocols, which use multiple instruments with tedious, manual sample-handling steps. In a further preferred embodiment, a stand-alone, battery-powered diagnostic platform with rapid analysis times and multiplexing capabilities will achieve statistical significance of measured quantities, with minimum consumption of human fluids (&lt;5 μl per sampling) using a hand-held smartphone-based system that can be used as a diagnostic tool by patients and medical professionals. 
     The microfluidic device utilizes a plurality of detection sites in fluid communication with a micro-scale sample inlet well for introducing and analyzing a small volume of sample fluid through capillary force. In one or more embodiments, the microfluidic device includes a substrate having a first major surface (e.g., top surface) and an opposing second major surface (e.g., bottom surface). In general, the top surface comprises a sample application region and at least one detection region. The detection region may generally occupy a space in the substrate having a volume of about 100 pL to about 1 μL. The sample application region is configured to receive an amount of the test sample (e.g., from about 10 μL to about 5 mL). The detection region comprises at least one nanosensor immobilized therein/thereon for detection of a biomarker in the sample. The substrate can be a woven or nonwoven solid support, which can be elongated or of various other geometric configurations. 
     The sample application region is in capillary flow communication with the detection region whereby a sample absorbed on the microfluidic substrate may flow by capillary action through the solid support from the sample application region to the detection region. Accordingly, there is a region of the substrate between the sample application region and the first detection region that defines a first path of flow of the material (i.e., a channel in/on the substrate from the application region to the first detection region). The substrate can be a test strip or ribbon (with two terminal ends) or other suitable geometric shape to facilitate flow of the material from the sample application region to the detection region. The top surface of the substrate will typically be substantially planar or flat, so as not to impede the flow or the sample, and comprise a porous membrane matrix with a suitable thickness that allows flow through of the test sample (liquid). The substrate can include a plurality of detection regions, each in fluid communication with the sample application region. This can include a plurality of channels extending between the sample application region and a respective detection region. It can also include a plurality of detection regions linearly or sequentially spaced along a single channel. 
     For fabrication, any suitable approach can be used to create hydrophobic regions in the substrate and thus define the hydrophilic channels to direct the flow of the test sample from the sample application region to (and past) the detection region(s). For example, the configuration of the channel(s) can be created using photosensitized polydimethylsiloxane (PDMS). The porous substrate is soaked in the PDMS and then the PDMS-soaked matrix is be patterned using a mask and an appropriate light source shone through the mask to transfer the mask pattern to the PDMS-soaked porous substrate. The PDMS in the exposed regions is cross-linked and the PDMS in the unexposed regions can be rinsed away using an organic liquid. These rinsed regions are hydrophilic and define the channels through which the sample flows. The photosensitized PDMS is amenable to large-scale mass production of sensor chips at ultra-low cost. Wax printing can also be used to pattern and define the channel architecture for higher throughput if necessary. 
     The developed nanosensors are pre-immobilized in each detection region of the substrate. An example of an approach for immobilization on cellulose is illustrated in  FIG. 6 . The nanosensors contain different recognition sequences for the target analyte or biomarker in the sample, and can be selectively pre-immobilized in each detection region, for example, through a needle-based pressure pull of reagents at the edge of the region. The detection regions containing the nanosensors are spatially separated. Therefore, a bandpass filter and a mask featuring pinholes are sufficient to observe the presence or absence of the detectable signal from clearly isolated regions. Thus, the collected sample is added to the sample application region and flows by capillary action to (and over/through) each detection region containing the nanosensors. 
     The microfluidic substrate can be any material that facilitates flow of the biological sample from the sample application region to the detection region(s) via capillary action. Thus, any porous or sorbent material (or combination of sorbent materials) can be used for the substrate, as long as it is capable of absorbing, either by capillary action or otherwise, molecules that pass through/along the substrate. For example, various sorbent materials (or combinations of sorbent materials) can be used, such as 100% cotton cellulose fiber (e.g., Whatman #1 filter paper or a similar type of material). Cellulose-based materials are particularly suited for use as test strips. In one or more embodiments, the device further comprises a wicking pad at or near the terminal end of the substrate (opposite the sample application region), with the detection region(s) being positioned therebetween. Thus, the sample, after being applied to the sample application region, wicks along the channel(s) in the substrate, causing the fluid sample to pass over the detection region(s) as it is “pulled’ towards the wicking pad positioned near the terminal end of each channel (opposite the sample application region/inlet). Preferably, the detection region is positioned nearer to the sample application region than to the wicking pad. Other suitable materials for the substrate include other lateral flow assay materials, such as nylon, paper, polymers (e.g., polyester, polystyrene, polyacrylamide, nitrocellulose), and activated forms thereof. 
     A miniature foil heater/thermocouple can be integrated into the substrate at the detection region, if desired, to facilitate interaction of the sample with the nanosensors. 
     The test article further includes a cartridge for containing the solid support. The heater can also be part of a cartridge for the solid support, so long as it remains in physical contact with the solid support. Both the cartridge and solid support can be single use and disposable. The cartridge may also be reusable. In embodiments, the cartridge can be made from bio-degradable plastic. The cartridge body will generally include a bottom support structure configured to be positioned underneath the solid support (and adjacent the second major surface), and a top support structure configured to be position on top of the solid support (and adjacent the first major surface). The top support structure includes openings for depositing the biological sample and viewing changes in the nanosensors in detection region(s). The opening for deposition of the biological sample defines a sample inlet well with a sidewall extending from the opening to a bottom wall for containing the sample, where the bottom wall of the microwell is defined by the top surface of the solid support. The volume defined by the inlet well can range from about 10 μL to about 5 mL. The opening above the detection microwells can be a true “open” through-hole, or may simply be a clear viewing window. 
     An exemplary device is illustrated in  FIG. 7 . The device further includes a housing that can be attached to a smart device and analysis cartridge. A permanent (non-disposable) housing can be used, which contains the detection optics and electronics necessary to control device heating and the assay timing. The cartridge contains the sample well, microfluidic substrate, conductivity pads, and a thin film foil heater. In use, a sample (e.g., ˜2 mL of BALF fluid or ˜2 mL of (lysis) buffers containing biospecimens) is added to a device with a parallel fluidic manifold as depicted. For example, the substrate includes 8 parallel channels with 6 of the channels containing a single optical-based nanobiosensor (OBN) readout pad. The 7th channel contains a positive control, and the 8th channel a negative control. The biosensors will be attached to the substrate using, for example, polysilazane attachment chemistry. All types of described nanosensors, including cytokine sensors described herein, as well as protease sensors, and arginase sensors, are adaptable to the microfluidics device. The polysilazane chemistry also allows a new approach to the nanosensor development where the primary florescent indicator is embedded directly into the polysilazane matrix as it is applied and the probe and quencher are attached afterward to the surface of the matrix. It will be appreciated that a variety of alternative cellulose linking chemistries are known in the art for immobilizing the nanosensors in the detection region(s). 
     After centrifugation, 500 μL of the BALF sample will be loaded into the sample inlet and evenly dispersed across the 8 channels through capillary action. The device design facilitates analysis of the sample without requiring pre-separation of the biological sample constituents. Thus, the nanosensor detection regions are positioned near the sample application region/inlet to reduce potential protein adsorption to the substrate fibers. In some embodiments, the substrate can be passivated/blocked using BSA or other blocking proteins (e.g. casein), or the substrate could potentially be coated with poly(ethylene oxide) or poly(ethyleneglycol) to reduce peptide/protein absorption. A wicking material is positioned at the terminal end of each channel to facilitate capillary flow of the entire volume of the sample across each detection zone. 
     Readout time can be automated. A conductivity detector can be used to mark the 0 time point when the sample inlet is wetted with the sample to quantitate the flow rate of the sample (i.e., the volume of sample that has passed over the detection region over a certain period of time). In general, the readout/detecting can be carried out anywhere from about 1 minute to about 20 minutes after the sample is introduced into the device. If sample viscosity varies significantly and adversely affects the rate of flow in the substrate, additional conductivity detectors can be spaced along the channel so that the readout time is based upon the total volume of sample passed over the nanosensor detection region(s). Fluorescence signal is best detected from the top 10 μm of the substrate so flow can be optimized to allow diffusion through the matrix to maximize signal. Channel dimensions and substrate wettability can be adjusted to provide a readout time of &lt;10 min. 
     In one embodiment, upon interaction with the analytes in the sample with the nanosensor, a change may be detectable in the detection region. For example, in the presence of a target protease, the fluorophore (or quencher) is released from the nanosensor such that the fluorophore is no longer quenched. Thus, the fluorescence can be detected in the detection region, indicating that the target protease is active and present in the sample. For example, the maximum absorption of the TCPP is near 420 nm, so an inexpensive 420 nm LED or any other time of laser diode can be used for excitation of nanosensors using TCPP as the detectable particle. Collimating and beam shaping optics can also be used to create a narrow excitation line across the channels where the detection spots were laid down. COMSOL multiphysics simulations can be used to adjust the beam shaping optics to provide even illumination across all of the detection. The fluorescence emission will be collected through a 660 df 20 nm bandpass filter and imaged on a cell phone camera CCD for detection. It will be appreciated that the nanosensors are not limited to the TCPP-cyanine FRET pair exemplified in the examples. Any FRET sensing pair can be used. If other FRET pairs are used then the excitation wavelength and optical filters can be modified accordingly. 
     The turnover rates for the analyte enzymes are highest at 36° C. so a miniature foil heater/thermocouple can be integrated into the substrate. The heating can be controlled with PID software. The foil heater and thermocouple can also be moved off the disposable cassette and into the permanent housing with the optical detection system. The extent of the heated zone on assay performance can be identified in terms of potential diffusion and evaporation issues. 
     For example, if a 500 μL sample of BALF fluid is divided into 8 channels (6 for analytes and 2 for controls) that means each sensor will be exposed to about 60 μL of fluid. Clinically relevant biomarker concentrations are expected to be 10 −11  to 10 −8  M. The total number of moles for the lower expected concentrations should therefore be ˜6×10 −16  moles which is well above the detection limit of the sensors. It will be appreciated that larger BALF volumes can be collected and so the volume used can be increased or the nanosensors can all be deposited in a single channel to further increase the number of moles of analyte they are exposed to. In this approach, the nanosensors would utilize a variety of different fluorophores with minimal spectral interference. Or, alternatively, the density of the sensors or the sensing region could be increased. The device will simultaneously measure at least 1 and as many as 20 biomarkers. Preferably, the device will measure between 3 and 15 biomarkers. More preferably, the device will simultaneously measure between 6 and 10 biomarkers. 
     Furthermore, relying on “paper” microfluidic technology will permit powering the device using the smart device battery only, without the need of an additional power source. Battery and supercapacitor technology is already available for powering extended applications of the device in locations without access to the electrical power grid. In future incarnations of the device, sample processing can be added to the sample inlet to filter out particulate matter so that centrifugal pretreatment of the sample will not be necessary. The most likely material for such pretreatment will be a polysulfone filter. This step will result in further reduced costs for the whole measurement process. 
     In a further preferred embodiment of the current invention, the relative optical density image analysis will be accomplished via a cross-platform smart device application written in Java for quantitative fluorescence measurement. LED field illumination with λ=420 nm, which completely covers the microwell chip region and allows the simultaneous detection of biological markers in the microwells. A collimating lens and a band-pass center wavelength of l=650 nm (625 nm-675 nm) will be attached to a 5×lens for eliminating unwanted background noise and enhancing the signal-to-noise ratio for imaging of TCPP-fluorescence. 
     In a preferred embodiment of the current invention, diagnostic results are displayed on smart phone of smart tablet and can be used to assist disease management and progression. Numerous learning algorithms are capable of capturing significant correlations between data sets by modeling the distribution of the data by introducing latent, or hidden, variables. Typical examples for this methodology are neural networks or factor analysis. The major advantage of Generative Topographic Mapping Algorithms (GTM) is that they can be extended to allow non-linear transformations while remaining computationally tractable. See  FIG. 8 . GTM is based on a constrained mixture of Gaussian functions whose parameters can be optimized using EM (expectation-maximization) algorithms. GTM algorithms are principally superior to Self-Organizing Map (SOM) algorithms, which do not define probability densities. GTM algorithms can be successfully utilized for the visualization and fast analysis of large arrays of chemical data. Various data distribution functions resulting in various probability distribution functions (e.g. data density and property landscapes) can be selected. Furthermore, GTM algorithms are very suitable for processing BIG DATA, if the necessity should arise in the future. 
     Thus, the smart device-based detection technology can be used for detection of protein signatures indicating the presence of regional epithelial injury or infection in airway samples or exhaled breath condensates; a nanosensor for point of care testing for monitoring the airway for the presence of inflammation from infection and/or environmental injury; a point of care device to diagnose or to triage children or adults with asthma for the presence of lower respiratory tract involvement; a smart-phone based device for real time monitoring of the impact of environmental exposures in home or industrial environments on the health of airway; a device for assessing progression of infection or resolution of infection in an outpatient setting; and a device for measuring response to therapy in patients with asthma or viral induced airway infections. 
     The use of the present nanosensors enables limits of detection (LOD) for proteases, post-translational modification enzymes (e.g., Arginase) and Cytokines/Chemokines that are significantly lower than picomolar. This technique is approaching femtomolar and sub-femtomolar LOD for numerous proteases and arginase. For cytokines, the technology is currently at LODs of about 10 −14  moles L −1 . In contrast, immunoassays (ELISA), which rely on antibodies or antibody fragments, have LOD that are only sub-picomolar (10 −12  to 10 −13  moles L −1 ). An additional complication of immunoassay technology is that numerous antibodies are promiscuous and show significant off-target binding. That limits the number of targets that can be measured, whereas the inventive nanosensors and related methods involve highly specific recognition sequences, avoiding non-specific binding and interaction (and as such, false-positive or negative results). The present nanosensors can achieve LODs of from about 10 −9  M to about 10 −18  M. 
     The use of microfluidic devices has the advantage of processing the liquid biopsies within minutes, whereas competing technologies require several hours to reach their (respective) maximal LOD. Furthermore, microfluidic devices are capable of lowering the LOD by another one or two orders of magnitude. Therefore, the combined microfluidics and nanosensor technology is significantly faster and more sensitive than competing technologies. 
     Microfluidic technology also facilitates multiplexing. A unique advantage of this technology is that different biomarkers (e.g., several proteases, cytokines and kinases) can be measured in one liquid biopsy. That is, the technology permits simultaneous detection of different classes of biomarkers in a single platform—an approach previously limited to mass spectrometry. Further, the level of sensitivity far outperforms what can be achieved with MS, and also permits real-time detection and results. This enables the “Barcode Detection Principle”, which is looking at 10-20 biomarkers for each disease. Looking at multiple biomarkers permits the differentiation between related diseases (e.g., lung inflammatory diseases vs. asthma) and the detection of diseases in very early states. The latter is, for instance, important for lung cancer detection, because cancer survival significantly increases when it is detected at stages 0 or 1, compared to 3 or 4. It is noteworthy that multiplex immunoassay technology exists (e.g. from Abcam), however, it still requires one antibody per bead or well. These beads/wells are combined to an array. This is conceptually different from the inventive technology. 
     Importantly, the nanosensor and methods measure the activity of target proteins and enzymes, as well as their concentrations and relative ratios. This is unique, because all antibody-based detection technologies utilize epitopes for target binding. They are not capable of sensing whether the enzymes are active or not. These enzymes are usually expressed as zymogens (inactive enzymes), which require either proteolytic activation or activation via posttranslational modification. Many of them show signaling activity when they are zymogens and enzymatic activity after activation. For the diagnosis of a disease, it is very important in what state (zymogene vs. active enzyme) a biomarker is. The present technology can provide that insight. 
     Further, this detection technology can be extended to capturing exosomes and measuring the activity of enzymes that are either bound to the exosomes surfaces or (after lysing) incorporated into exosomes. Further, lysis of the exosomes will permit the determination of the activity of enzymes or the concentration of cytokines that were contained in the exosomes&#39; interior. Lysed exosomes can also be assessed for RNA and metabolites as markers of exosomal activities and function, as well as inflammation-induced changes in protease, kinase, or cytokine activity. Cancer-induced changes in phosphatases (e.g., alkaline phosphatase) and DNA/RNA synthesizing/modifying enzymes (e.g., ribonucleotide reductases or DNA/RNA helicases) in exosome content can also be quantified using the technology. The detection technology also permits direct or indirect assessment of exosomal stability and activity. Although the microfluidic platform is preferred to use in isolating the exosomes for analysis with the nanosensors, it will be appreciated that exosomes can alternatively be prepared and extracted using conventional technique of centrifuging the samples at low to high g for optimum duration, yielding a pellet containing exosomes that can be characterized using nanosensors described herein, in order to monitor and characterize exosomal activities and function defined by quantification of changes in protease, cytokine, and/or kinase secretion. 
     Additional advantages of the various embodiments of the invention will be apparent to those skilled in the art upon review of the disclosure herein and the working examples below. It will be appreciated that the various embodiments described herein are not necessarily mutually exclusive unless otherwise indicated herein. For example, a feature described or depicted in one embodiment may also be included in other embodiments, but is not necessarily included. Thus, the present invention encompasses a variety of combinations and/or integrations of the specific embodiments described herein. 
     As used herein, the phrase “and/or,” when used in a list of two or more items, means that any one of the listed items can be employed by itself or any combination of two or more of the listed items can be employed. For example, if a composition is described as containing or excluding components A, B, and/or C, the composition can contain or exclude A alone; B alone; C alone; A and B in combination; A and C in combination; B and C in combination; or A, B, and C in combination. 
     The present description also uses numerical ranges to quantify certain parameters relating to various embodiments of the invention. It should be understood that when numerical ranges are provided, such ranges are to be construed as providing literal support for claim limitations that only recite the lower value of the range as well as claim limitations that only recite the upper value of the range. For example, a disclosed numerical range of about 10 to about 100 provides literal support for a claim reciting “greater than about 10” (with no upper bounds) and a claim reciting “less than about 100” (with no lower bounds). 
     EXAMPLES 
     The following examples set forth methods in accordance with the invention. It is to be understood, however, that these examples are provided by way of illustration and nothing therein should be taken as a limitation upon the overall scope of the invention. 
     Example 1 
     Nanosensor Preparation 
     In this Example, a nanosensor for detecting cytokine activity was prepared. The oligopeptides are synthesized by solid phase synthesis. The fluorescent dye is attached while the oligopeptide is still on the column. After cleavage from the resin (Wang resins are used), the oligopeptide is dialyzed, lyophilized and then purified by means of gel chromatography. Typical purities are 85% after synthesis, 95% after dialysis and 99++ percent after gel chromatography. The following supramolecular recognition sequence was used for IL-6: NRPAQAWMLG (SEQ ID NO:21) 
     Synthesis of Peptide Sequence. 
     A commercially available dry resin (purchased from Peptides International) with the starting amino acid (500 mg) was placed in the reaction vessel. Next, 4 ml DCM was added until all resin beads are immersed to swell the resin in the DCM for 20 minutes. This helps the resin to react well with the next amino acid to be added. The resin suspension was gently swirled for 20 min. Then the DCM was removed by filtration under vacuum. 
     The first N α  Fmoc deprotection was performed using 4 ml 80/20 DMF/diethylamine solution. The mixture was stirred for 1 min and the solution was then removed by vacuum filtration. The same step was repeated within 10 min. The resin was then washed five times with 4 ml of DMF by stirring it for 30 s. The solvent was removed by vacuum filtration. 
     To add the second amino acid to the resin, the N α  Fmoc protected amino acid (Resin:Amino acid=1:3 molar) and HBTU (Resin:HBTU=1:2.9 molar) was dissolved in 9.6 ml of DIEA/DMF (1:23 v/v) solution. The mixture was then added to the resin in the vessel and stirred for 30 min. This step is repeated once to increase the probability of binding the amino acid to the resin. Then the coupling solution was removed by vacuum filtration. Washings were performed with 4 ml DMF for 30 s four times. 
     The desired peptide sequence was assembled in a linear fashion from the C-terminus to the N-terminus (the C_N strategy) by repetitive cycles of N α  deprotection and amino acid coupling reactions. Deprotection and coupling processes are repeated until the desired sequence is obtained. The TCPP (tetrakis-4-carboxyphenyl-porphyrin) dye is attached to the N-terminal of the peptide sequence utilizing the same procedure as if adding an amino acid. 
     Resin:TCPP molar ratio was 1:3. After the addition of dye to the resin, it was swirled for 24 hrs at RT and the excess dye was washed off with DMF solution. 
     In order to release the peptide from the resin, it was swelled with DCM. Then 4 mL of cleavage cocktail (trifluoroacetic acid/water/triisopropyl silane 3.8/0.1/0.1) was added to the resin. The resin was swirled gently for 3 hrs at RT. Then it was filtered into 20 ml cold diethyl ether. The peptide sequence was precipitated and was washed with cold ether three times. The precipitate was isolated by centrifugation (10000 rpm, for 5 min). Finally, argon was applied to dry the product for safe storage. 
     The oligopeptide was purified by quantitative HPLC. MALDI-TOF (Matrix-assisted laser desorption/ionization-time of flight mass spectrometry) was used to characterize the peptide sequence. 
     Synthesis of Nanosensor: 
     To assemble the cytokine nanosensor, 100 mg of Fe/Fe 3 O 4  nanoparticles was mixed with 16.5 ml of distilled DMF, 14.13 mg of TCPP-bound peptide sequence, 10.0 mg of EDC, and 10.0 mg of DMAP. The mixture was stirred at room temperature for 24 hrs and the excess dye was removed by dialysis. The end-product was lyophilized. 
     Example 2 
     Nanosensor Calibration 
     The nanosensors can be calibrated according to the following procedures. Calibration of the IL-6 nanosensor was conducted with commercially available recombinant human IL-6 to validate the sensing capabilities. The calibration curves are recorded as a function of IL-6 concentration. Commercially available recombinant human IL-6 purchased from BD Biosciences was used. Concentrations ranging from 1.0×10 −16  mol dm −3  to 1.0×10 −8  mol dm −3  were utilized for the calibration process. Plate reader technology was used to measure the fluorescence signals. Five replicates from each concentration were analyzed in order to get accurate data. Recombinant human IL-6 is stored at −80° C. The assay procedure was as follows: 
     A Biotek FL800 plate reader (tungsten halogen lamp, excitation bandpass filter: 421±10 nm, analysis bandpass filter: 650±25 nm) with 96-well plates was used. The plate reader was set to 25° C. Distilled water was used for all procedures. 
     Solution (1): HEPES (25 μmol) buffer (2-[4-(2-hydroxyethyl) piperazin-1-yl]ethanesulfonic acid) prepared with Ca(II), Mg(II), and Zn(II)-enriched (10 μmol each) at 300 K (pH=7.2). Solution (2): Fe/Fe 3 O 4  based nanoplatform was prepared by dispersing 0.3 mg of the nanoplatform 1.0 mL of HEPES buffer by sonication for 10 min at 25° C. 
     The following samples were prepared by adding solution (1) or nanoplatform (2) with 5 μL of commercially available L-6 sample; A: Sample Control (125 μL of solution (1)+5 μL IL-6 sample); B: Assay (125 μL of assay (2)+5 μL IL-6 sample); C: Assay Control (125 μL of nanoplatform (2)+5 μL of solution (1)). Each sample (total 130 μL) was loaded into one of the wells of 96-well plates. The solutions were incubated at 37° C. for 60 min and minimum five replicates of each assay were prepared. Detection of nanoplatform fluorescence was performed utilizing a 96-well fluorescence plate reader (BioTek Synergy 2) at 421 nm excitation wavelength. 
     Using the integration of the fluorescence decay graphs, calibration curves were recorded. The data is presented in the table below, as well as in  FIG. 9 . 
     Calibration with Commercially Available Interleukin-6 (Enzo Lifesciences) 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
               
                   
                 Concentration 
                 (Sample-Sample control)/Assay control 
               
               
                   
                   
               
             
            
               
                   
                 ×10 −8   
                 0.9795 
               
               
                   
                 ×10 −9   
                 0.9064 
               
               
                   
                 ×10 −10   
                 0.8260 
               
               
                   
                 ×10 −11   
                 0.7163 
               
               
                   
                 ×10 −12   
                 0.6558 
               
               
                   
                 ×10 −13   
                 0.6167 
               
               
                   
                 ×10 −14   
                 0.5847 
               
               
                   
                 ×10 −15   
                 0.5309 
               
               
                   
                   
               
            
           
         
       
     
     Example 3 
     Development of Recognition Sequences 
     The supramolecular recognition sequences were developed according to the following procedure: A) The primary structure of the target was retrieved from a data bank (e.g. UniProtKB or Protein Data Bank). B) The tertiary structure of the target was determined and then refined utilizing protein structure predicting software, such as the GalaxyWEB protein structure prediction cluster, developed by Dr. Seok at the Computational Biology Lab, Seoul National University, Korea. C) The primary structure of a monoclonal antibody (MAB) fragment against the target was retrieved from a data source (e.g., Protein Data Bank, SciFinder, or information provided by the vendors of antibodies). A tertiary structure was generated using GalaxyWEB. D) A docking procedure between the target and antibody chain is simulated using the Mobyle platform developed by the Institut Pasteur Biology IT Center, Paris, France. This procedure reveals the “true” epitope of the target. E) A final “site finder” procedure is then performed on the Mobyle platform docking the epitope of the target to the improved structure of the antibody (Ab) fragment. This structure reveals the peptide sequence of the Ab fragment that is actually responsible for binding to the target. 
     If this sequence was linear, it was synthesized and used as a recognition sequence for the nanosensors. If it was not linear, or if the LOD of the resulting nanobiosensor was not at least 10 −14  M, the in silico procedure was be repeated using the structural information from another mAb. 
     Example 4 
     Detection of MMPs and Cytokines in Exhaled Breath Condensate 
     Exhaled breath condensate (EBC) samples from the UTMB biorepository bank were analyzed using nanosensors containing detection sensors for various biological markers. The EBC samples had been collected from three human subjects who did not show any signs of asthma, and three who were diagnosed with mild asthma (no corticosteroids). For these experiments each EBC sample was first mixed 1:1 (v/v) with Ca(II), Mg(II), and Zn(II)-enriched (0.35 mmol each) HEPES buffer (2-[4-(2-hydroxyethyl) piperazin-1-yl] ethanesulfonic acid) at 300K (pH=7.2). This mixture was then incubated for 60 min at 37° C. with respective nanosensors for ADAM 33 (disintegrin and metalloproteinase domain-containing protein 33), granzyme A,B, MMP&#39;s 8 and 9, neutrophil elastase (NE), and the cytokines MCP-1 (monocyte chemotactic protein 1) and MIP-1 (macrophage inflammatory protein 1) in HEPES buffer. Detection of nanosensor fluorescence (λ exc =421 nm, λ em : 680-720 nm) was performed utilizing a 96-well fluorescence plate reader (BioTek Synergy H1). For granzyme B (all three patients diagnosed with mild asthma), and neutrophil elastase (one patient), distinct differences in the enzyme activities in EBC between the mild asthma group and control group were found. Elevated levels of MMP 13 were not detected in either group. The levels of MMP8 (not shown) and MMP9 varied from subject to subject, but were clearly measurable. Individual levels of MCP-1 and MIP-1 were present in the ECB samples of all six human subjects. An important outcome of this experiment is that these important biomarkers (e.g., MMPs, granzymes, and cytokines) are present at readily measurable levels (picomolar to sub-nanomolar) in ECB. The results are presented in  FIG. 10 . 
     Example 5 
     Detection of MMPs and Cytokines in Mouse Bronchoalveolar Lavage Fluid 
     In preliminary studies, the lungs of nine mice were treated with phosphate buffered saline (PBS, group A), the immunostimulant polyinosinic:polycytidylic acid (poly IC) was administered to eight mice (group B) to induce lung injury and inflammation, and five mice were given Respiratory Syncytial Virus (RSV) to induce airway infection (group C). Bronchoalveolar lavage fluid (BALF) samples were collected from each mouse, and measured for various biomarkers. Among other proteases and cytokines, MMP-8, neutrophil elastase (NE), granzyme B and MIP-1 were measured in the BALF samples. Based upon the results, the administration of PBS has caused an immune reaction. All four biomarkers indicate that the mice in group B reacted to receiving poly(I:C), whereas a weaker immune reaction to RSV was observed in group C. The results are presented in  FIG. 11 . 
     1) Detection of Exosomes Via Light Scattering 
     A) Unfrozen bronchoalveolar lavage fluid (BALF) from untreated mice was diluted 1:1 with HEPES buffer. 
     B) 10 microliters of this mixture were mixed with 1.0 mL of HEPES buffer for measuring the hydrodynamic diameter of the exosomes (d=710 nm). 
     C) 10 microliters of a dispersion of 1.0 mg Fe/Fe 3 O 4 -nanoplatform bearing 75+/−5 peptide aptamers for binding of the tetraspanins CD9, CD 63, or CD81, in 1.0 mL of HEPES buffer were mixed with 1.0 mL of HEPES buffer for measuring the hydrodynamic diameters of the nanoplatforms for exosome detection: 
     Fe/Fe 3 O 4 -CD 9: 296+/−10 nm 
     Fe/Fe 3 O 4 -CD 63: 384+/−15 nm 
     Fe/Fe 3 O 4 -CD 81: 634+/−20 nm 
     Since the diameter of individual Fe/Fe 3 O 4 -nanoparticles is approx. 20 nm, as measured by TEM, these findings are a clear indication that clustering between individual Fe/Fe 3 O 4 -nanoparticles occurs. 
     D) 10 microliters of exosome-containing HEPES buffer and 10 microliters of CD (9,63, or 81)-nanoplatform—containing HEPES buffer were added to 1.0 mL of HEPES buffer and vortexed for 10 s. Then, the hydrodynamic diameter was measured at 298K as a function of time. The results are summarized in  FIG. 12 . From the data, the following conclusions can be drawn:
         Shortly after incubating the exosomes and the nanoplatforms with targeting peptide aptamers, significant increases in the observed hydrodynamic diameters can be seen. This can be interpreted as evidence that the exosomes promote the clustering of the nanoplatforms. This is a highly dynamic process, which is not finished after 140 min. However, the presence of exosomes can be detected with certainty 10 min. after incubation.   Each of the nanoplatforms bearing CD9, CD63 and CD81 has different binding efficacies, or, alternatively, the three tetraspanins are not available in equal concentrations at the exosomes&#39; surfaces.   Incubation of at least 1 h is recommended if the exosomes should be magnetically captured for subsequent lysis and analysis of their protein, DNA and RNA content. However, this is not necessary for detecting the presence of exosomes.       

     2) Detection of Exosomes Using Electrical Impedance Measurements 
     Electrical Impedance Spectroscopy is a powerful electrochemical method for the characterization of interfaces. The underlying equation is an expression analogous to Ohm&#39;s Law that permits calculating the impedance of a system as: 
     
       
         
           
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     Z0: Impedance, ϕ: Phase Shift (Phase Angle) 
     The Phase Angles as a function of applied frequency ω were investigated in 0.10 M HEPES buffer.  FIG. 17  shows the observed phase angles for the following compositions:
         0.10M HEPES buffer   100 microliters of this exosomes/HEPES 1:1 v/v were mixed with 1.0 mL of HEPES buffer for measuring the hydrodynamic diameter of the exosomes   10 microliters of a dispersion of 1.0 mg Fe/Fe 3 O 4 -nanoplatform bearing 75+/−5 peptide aptamers (see Table 1) for binding of the tetraspanin CD 81, in 1.0 mL of HEPES buffer were mixed with 1.0 mL of HEPES buffer.   100 microliters of exosome-containing HEPES buffer and 10 microliters of CD 81-nanoplatform—containing HEPES buffer were added to 1.0 mL of HEPES buffer.       

     All mixtures were constantly purged with N2 for 10 min before and during the measurements. All measurements were repeated three times. It is noteworthy that the supramolecular associates between exosomes and nanoplatforms bearing 70 peptide aptamers for CD 81 recognition can be discerned in the low frequency range (1-10 Hz) of  FIG. 13  (which is a so-called Bode Phase Plot). This offers, principally, an opportunity for the fast recognition and differentiation of exosomes in a Point-of-Care Device (POCD). The nanoplatforms for CD 9 and CD 63 detection showed, principally, the same behavior. 
     Example 6 
     Microfluidic Device Valve and Pump Design 
     In this example, a new design paradigm for a dielectric actuator for fabrication of both valves and pumps on microfluidic devices is described. An exemplary design is shown in  FIG. 14 . In this design the fluidic channel is sandwiched between a liquid compliant electrode (top) and a planar electrode (bottom). When an electric field is applied between the two electrodes the dielectric layer and fluidic channel between them changes shape due to the force generated between the electrodes. As the dielectric is not compressible, the dielectric layer must change shape as discussed above. The easiest method to relieve the stress is to compress the fluidic channel thus pinching off the channel between the 2 electrodes. This effectively forms a valve, which under unpowered conditions is normally open. In order to minimize the distance between the two electrodes without exceeding the electrical breakdown capacity of the dielectric, a thin insulating (dielectric) layer may be applied between the bottom electrode and the fluidic channel. This layer may formed of silicones, titanium oxides, titanates (e.g., Sr and Ba) or perovskite materials that have significantly higher electrical breakdown potentials than PDMS or other types of elastomers. In addition, such surfaces have functionalities that make them suitable for modification and the attachment of sensing species as described below. 
     By creating 3 normally open valves along a channel ( FIG. 15 ) a peristaltic pump can be created that is improved over pneumonic actuation. That is, pneumatic actuation requires significant off chip equipment, and the solenoid valves used to operate the gas lines are power intensive. In addition, liquid/air tight seals with the chip must be made for all of the valve control lines. Dielectric valves, conversely, do not require air/liquid tight interfaces. Connections to electrical power supplies can be made using small, flexible wires or pins. The capacitance of the actuators is low and so little power is required to drive the valves. This allows high voltage/low current power supplies to be used for actuation. Such supplies could even be powered using computer USB ports. In such designs, a single power supply can be used with several high voltage switches. The switches can be opto-diodes. Such switches can work at speeds of over a kHz. They are compact and inexpensive. 
     A design for an exemplary robust point of care (POC) system that can be used for disease diagnosis is shown in  FIG. 16 . In this device, two recirculating microfluidic loops are used to first concentrate a biologically significant molecule or species (e.g., exosomes), from a biological sample (e.g. blood, sputum, nasal lavage, etc.) and then to detect the biological marker(s) using a variety of sensing platforms. In the first loop, a volume of several mL of biological fluid can be loaded into the loop displacing a sterile PBS type buffering system. The fluid is first loaded into an input reservoir. Valves V1 and V3 are opened while valves V2, V4, and V5 are closed. The pump in loop one (LOOP1) is opened and the sample drawn into the loop as the PBS is displaced and sent to waste. Once LOOP1 is filled. Valves V1 and V3 are closed and valve V2 is opened. The sample is then recirculated over the capture pad CP1 until a sufficient quantity of the analyte (e.g., species, exosome, etc.) is captured. The capture may be attained using a variety of affinity agents including but not limited to antibodies, aptamers, peptide aptamers, Fab fragments, etc. Once captured and concentrated on CP1, pump P1 will be stopped. Valves V4, V5, V7, and V8 will be opened. Pump P1 valves will be closed along with valve V6. Pump P2 will then be actuated to pull lysis buffer out of side channel SC3, over the capture pad CP1 and into the second loop. The concentrated analytes released from CP1 will flow through LOOP2 displacing the sterile PBS solution in that loop. The displaced sterile PBS will exit through side channel SC4. After filling LOOP2 with the concentrated analyte, valves V5 and V8 will be closed and valves V6 and V7 will be opened. This will allow the recirculation of the analytes in LOOP2 over the sensor pads. The recirculation will continue to occur until a sufficient of biomarkers if present are captured to produce a detectable signal. 
     The device material used to fabricate the microfluidic channels and the compliant electrode can be a silicone, modified silicone or acrylic elastomer. These materials are highly transparent. The bottom electrode can be made from indium tin oxide (ITO) deposited on a thin glass slide, as the ITO and slide are transparent and will allow easy observation and troubleshooting of the device. The non-compliant electrode material, however, can be any electrically conducting substance. Between the stationary electrode and the fluidic channels a high dielectric coating will preferably be used. This coating may be a silicone, acrylic, cellulose acetate, or barium (or strontium) titanate, among others. The bottom non-compliant electrode may cover the entire bottom plane of the device and serve as a ground plane or high voltage plane. The valves would then be actuated by applying a potential to the compliant electrodes or grounding them if they are otherwise floating. Alternatively, all of the compliant electrode channels can be grounded and the non-compliant electrodes patterned individually on the glass slide. In this configuration, the valves could be individually actuated either through switching the ground electrodes from floating to grounded or be applying a potential to one of more of the patterned non-compliant electrodes. 
     Example 7 
     Printable Detection Systems for Paper Microfluidic Devices 
     The disadvantage of all nanoplatforms/nanobiosensors for the detection of biospecimens of interest is that they have to be pre-assembled. The following modification permits the printing of the sensing nanoplatform in consecutive steps using conventional desk-jet technology. A fluorescent dye, preferentially with a high fluorescence or phosphorescence quantum yield (e.g. Rhodamine B) will be dissolved in an inorganic solvent (e.g. a hydrocarbon, an ether, or an ester), together with a polysilazane designer polymer: 
     
       
         
         
             
             
         
       
     
     A mixture of rhodamine B, a polysilazane designer polymer (x, and z can be varied from 0-100 percent, y from 0-25 percent); n,m are between 1 and 100,000 will be dissolved in a solvent without functional groups featuring polar hydrogens (—COOH, —OH, —NH, —SH, HX, etc). Typically, 1-10% by weight of the polysilazane designer polymer and 0-5 percent by weight of the polyethylene glycol derivatives are dissolved, leading to a stable “ink” (store in the dark and protect from humidity). This ink can be used to print spots of immobilized dyes onto cellulose paper. The surface will be hydrophilic, so that aqueous buffers can react with it. An exemplary protocol is below. 
     A: Printing of the Designer-polysilazane supported fluorescent dye (every fluorescent dye possessing a functional groups featuring at least one polar hydrogen) onto the paper. The polar hydroxy groups react either with the Si—H groups of the designer polysilazane under formation of H 2  and O—Si bonds, or they exchange Si—NH— against Si—O—, and NH 3  is eventually released. After 0-10 min of solvent evaporation and formation of a fluorescent dye containing coating, step B follows. This technology is forming sub-micrometer layers on immobilized fluorescent dyes on paper (or, more generally, substrates). 
     B1: Printing of an oligopeptide used in posttranslational sensors featuring 1-5 serines at their C-terminal ends (e.g., GRRRRRRRGSSS, SEQ ID NO:76), dissolved in DMF or any other dipolar aprotic solvent (DMA, acetonitrile) or methyl-group capped oligoethylene glycol, in which the oligopeptides are soluble. The —OH groups of the serine units at the C-terminal end react with the designer polysilazane under formation of H2 and O—Si bonds, or they exchange Si—NH— against Si—O—, and NH3 is eventually released. At the N-terminal end of the oligopeptide is a FRET partner or quencher attached, which is matched with the emission spectrum of the immobilized dye. 
     B2: The same reaction as described under B1 can be applied to print the “classic” consensus sequences onto the very thin layer of immobilized fluorescent dye. Again, we add 1-5 serines to the C-terminal end of the polymer. Principally, threonine or tyrosine would work as well. 
     B3: A different strategy has been devised for determining the concentrations of cytokines (protein targets) in paper microfluidic devices. The first oligopeptide that is printed onto the thin layer of designer-polysilazane immobilized fluorescent dye contains the paratope for binding the target (e.g., cytokines, growth factors, enzymes that don&#39;t cleave/chemically modify the oligopeptide tether). It contains 1-5 serines at its C-terminal end, as previously described. Serines are optimal, because they are hydrophilic and facilitate the aqueous buffers containing the target proteins to flow over the nanosensor capture area (instead of around it). The second oligopeptide contains the epitope of the original target. It will be displaced by the real target, which causes the release of the quencher, which is attached to the N-terminal end of the second oligopeptide. In order to make sure that the second oligopeptide is released by the target, and to provide a larger range of detection, a series of mutations are introduced in the second oligopeptide. This causes consecutively weaker binding to the first oligopeptide and, consequently, easier release. 
     C: Reaction Possibilities: 
     C1: Reaction with arginase (or other posttranslational modifying enzyme). The fluorescence is increased, because the distance between immobilized fluorescent dyes and quencher increases. 
     C2: Classic protease-cleavage reaction, except that the quencher is removed. 
     C3: The real target displaces oligopeptide 2, and together with it the quencher. Using Interleukin 13 as the example, Oligopeptide 1, to be bound to the surface of the polysilazane designer polymer: AVYYCQQNNEDPRTFGGGTKSSSG (SEQ ID NO:77). Oligopeptides 2: Dye-QFVKDLLLHLKKLFREGRFNG (SEQ ID NO:78), Dye-QFVKDSLLHLKKLFREGRFNG (SEQ ID NO:79), Dye-QFVKDSLLHLSKLFREGRFNG (SEQ ID NO:80), and Dye-QFVKDSLLHLSKLFRESRFNG (SEQ ID NO:81). One, two and three serines are introduced into the developed sequence. Each serine weakens the binding constant by approximately one order of magnitude. Virtually, any natural or unnatural amino acid, as well as D-amino acid at any position in the sequence can be used to weaken the binding and thus provide a greater range of measurements (if mixtures of oligopeptides 2 are bound to oligopeptide 1). 
     Example 8 
     Analysis of Cell-Type Differences in the Epithelial Secretomes 
     The invention is useful in the assessment of inflammatory response in the airways induced by the exposure of the airway to pathogens, allergens, and toxins by characterizing and quantifying the response of a patient&#39;s lower respiratory tract based on the analysis of protein patterns in the airway fluids and utilizing a novel sample collection device interfaced with smartphone and mobile computing platform. These proteins can be free-floating or bound in nanovesicles (exosomes). 
     RSV infections produce a variety of clinical syndromes including upper respiratory tract infections (with or without recurrent otitis media) and lower respiratory tract infections (LRTIs). Although the majority of infections produce an uncomplicated URI, in ˜2% of predisposed children RSV can spread into the lower airways, producing LRTI. RSV is consequently the most common cause of childhood LRTIs, responsible for 120,000 hospitalizations for LRTI (bronchiolitis) in the US annually, and represents the leading cause of infant viral death worldwide. Apart from its acute morbidity, severe LRTIs are associated with reshaping the pulmonary immune response, producing Th2 polarization and enhancing susceptibility to recurrent virus-induced wheezing through the next several decades of life. The mechanisms by which LRTIs reprogram the pulmonary immune system are not fully understood. 
     LRTIs from RSV are due, in part, to secreted signals from lower airway cells that modify immune response and trigger airway remodeling. To understand this process, we applied an unbiased quantitative proteomics analysis of the RSV-induced epithelial secretory response in cells representative of the trachea (hBECs) vs small airway bronchiolar cells (hSAECs). A workflow was established using telomerase-immortalized human epithelial cells that revealed highly reproducible cell type-specific differences in both secreted proteins and nanoparticles (exosomes). Approximately one-third of secretome proteins are exosomal, with the remainder from lysosomal and vacuolar compartments. We applied this workflow to three independently derived primary human cultures from trachea (phBECs) vs bronchioles (phSAECs). 577 differentially expressed proteins from control supernatants and 966 differentially expressed proteins from RSV-infected cell supernatants were identified at a 1% false discovery rate (FDR). Fifteen proteins unique to RSV-infected phBECs were regulated by epithelial-specific ets homology factor (EHF). 106 proteins unique to RSV-infected hSAECs were regulated by the transcription factor NFκB. In this latter group, we validated the differential expression of Chemokine (C—C Motif) Ligand 20 (CCL20)/macrophage-inducible protein (MIP)3α, thymic stromal lymphopoietin (TSLP) and chemokine (CC) ligand 3-like 1(CCL3-L1) because of their roles in Th2 polarization. CCL20/MIP3α was the most active mucin-inducing factor in the RSV-infected hSAEC secretome, and was differentially expressed in smaller airways in a mouse model of RSV infection. These studies provide insights into the complexity of innate responses, and regional differences in epithelial secretome participating in RSV LRTI-induced airway remodeling. 
     Materials and Methods 
     Cell Culture and Treatment. 
     Immortalized human bronchial epithelial cells (tert-hBECs) and small airway epithelial cells (tert-hSAECs) were established by transducing primary cells with human telomerase and cyclin-dependent kinase (CDK)-4 retrovirus constructs (22, 23). hBECs and hSAECs were grown in basal medium supplemented with growth factors (Lonza, Walkersville) in 10 cm Petri dishes in a humidified incubator with 95% air/5% CO 2  at 37° C. At 80-90% confluence, the medium was changed, fresh basal medium without growth supplements was added to the plates, and the cells infected with pRSV (MOI 1.0) for 24 h. Conditioned Medium (CM) was collected and centrifuged at 2000×g at 4° C. for 20 min to remove any dead cells. The supernatant was centrifuged at 10,000×g at 4° C. for 10 min to remove any cell debris. The supernatant was used immediately for secretome analysis. Cells from the same plates were lysed in Trizol for whole-cell protein preparation. Experiments were performed in biological triplicates. 
     For studies with primary human bronchial epithelial cells (phBECs) and phSAECs, cells from three different donors were obtained from Lonza. CM was prepared from hBECs or hSAECs 24 h post-infection (MOI=1.0). When indicated, CM for UV-inactivated RSV-infected cells was used to stimulate hBECs at a 1-25% (vol/vol) concentration for the indicated times. UV inactivation was as previously described (24). For antibody neutralization, 20 μL of RSV-CM was mixed with anti-CCL20 Ab (R&amp;D Systems, Minneapolis, Minn.). 
     Exosome Preparation. 
     Exosome isolation was performed by differential centrifugation at +4° C. to minimize protein degradation. Cells were removed by low-speed centrifugation at 400×g, 10 min. The cleared supernatant was then sequentially centrifuged at 2000×g for 15 min and 10,000×g for 30 min to remove any remaining cell debris/microvesicles. Exosomes were finally pelleted by ultracentrifugation at 100,000×g for 2 h and washed in PBS (without Ca++ or Mg++) at 100,000×g, 60 min. After washing, the pellet was resuspended in a total of 200 μL of PBS. Exosome size was estimated by dynamic light scattering using a Malvern High-Performance Particle Sizer (Malvern Instruments, Westborough Mass.). Data acquisition and analysis were performed using Dispersion Technology Software (DTS, V4.1.26.0) configured for HPPS analysis. Each experimental group had three independent replicates. 
     Preparation of Sucrose Cushion-Purified RSV (pRSV). 
     The human RSV A2 strain was grown in Hep-2 cells and prepared by sucrose cushion centrifugation as described. The viral titer was determined by a methylcellulose plaque assay. pRSV aliquots were quick-frozen in dry ice-ethanol, and stored at −70° C. until use. 
     Immunofluorescence (IF) Microscopy. 
     Airway cells were plated on cover glasses pretreated with rat tail collagen (Roche Applied Sciences). The cells were fixed with 4% paraformaldehyde in PBS, permeabilized with 0.1% Triton X-100, blocked in 10% goat serum, and incubated with primary rabbit polyclonal Ab to cytokeratin-7 or 19 as indicated. After incubation with Alexa-goat anti-Rb Ab, cells were washed and counterstained with 4′,6-diamidino-2-phenylindole (DAPI). The cells were visualized with a Zeiss fluorescence LSM510 confocal microscope at 63× magnification. IF of paraffin-embedded mouse lung was performed following standard protocols. Briefly, lung sections (5-μm) were deparaffinized in xylene and hydrated in ethanol (100%-70%). Sections were washed with deionized water. Antigen unmasking was done with 1.0 mM EDTA, pH8.0. Sections were washed in H 2 O and blocked with 10% goat serum for 1 h at room temperature in the dark, followed by primary antibody against CCL20 (1:200 dilution, Abcam) overnight at 4° C. in the dark. Sections were washed with TBS-Tween (0.1%) buffer and incubated with goat secondary Ab conjugated with Alexa 568 (DAKO) for 1 h at room temperature in the dark. Sections were washed in TBS-Tween (0.1%), incubated with DAPI for 1 min, mounted on coverslips and visualized by confocal microscopy (Zeiss) and photographed at 63× magnification. 
     Apoptosis Assay. 
     Apoptosis was measured using a commercial annexin V-FITC apoptosis detection kit following the manufacturer&#39;s protocol (BioVision, Milpitas, Calif.). Briefly, hBEC and hSAEC cells (1×10 6 ) were infected with or without RSV (MOI 1.0) for 24 h. Cells were dislodged with Accutase (Millipore), washed once with PBS and incubated with 5 μL of annexin V-FITC and 5 μL of Propidium Iodide (PI) in 500 μL of binding buffer for 5 min at room temperature in the dark. Annexin V-FITC and PI labeling was measured by flow cytometry. 
     Transmission Electron Microscopy (TEM). 
     A 10 μL aliquot from the exosome suspension was diluted in deionized water, applied to 200 mesh Formvar/carbon coated copper grids (Electron Microscopy Sciences) for 10 min at room temperature (24° C.) and negatively stained with 2% uranyl acetate (UA). The grids were examined in a Philips CM-100 transmission electron microscope at 60 kV FEI (Thermo-Fischer). Exosome images were acquired with a Gatan Orius 2001 charge-coupled device (CCD) camera. 
     Secretome Digestion. 
     About 10 mL of the CM supernatant was added into a 3K filter unit (Millipore, Billerica, Mass.) and centrifuged at 14,000×g for 15 min. 400 μL of 8 M urea was added into the filter unit and centrifuged at 14,000×g for 15 min, and this step repeated once. The solution remaining in the filter device was collected for protein digestion. Proteins were reduced with 10 mM dithiothreitol for 30 min, followed by alkylation with 30 mM iodoacetamide for 60 min in the dark. The sample was diluted 1:1 with 50 mM ammonium bicarbonate. Proteins were digested with 1.0 μg LysC-tr (Promega) for 12 h at 37° C. and then diluted 4:1 with 50 mM ammonium bicarbonate. The proteins were further digested with 1.0 g trypsin (Promega) for 16 h at 37° C. The digestion was stopped with 0.5% trifluoracetic acid (TFA) and the peptides desalted on a reversed-phase SepPak C18 cartridge (Waters); peptides were eluted using 80% acetonitrile (ACN). The eluate was dried in a SpeedVac and the peptides acidified with 2% ACN-0.1% TFA. 
     Cellular Proteome Digestion. 
     About 50 μg of proteins in 8 M guanidine were reduced with 10 mM dithiothreitol, alkylated with 30 mM iodoacetamide, sequentially digested with 1.0 μg LysC-tr and 1.0 μg trypsin as described above for secretome proteins. 
     Exosome Digestion. 
     The proteins present in the exosomes were separated from the lipid components by chloroform/methanol precipitation. After resuspension of the chloroform/methanol precipitation pellet in 45 μL of 8 M guanidine, proteins were reduced with DTT, alkylated with iodoacetamide, and sequentially digested with LysC-tr and trypsin as described above. 
     LC-MS/MS Analysis. 
     A nanoflow UHPLC instrument (Easy nLC, Thermo Fisher Scientific) was coupled on-line to a Q Exactive mass spectrometer (Thermo Fisher Scientific) with a nanoelectrospray ion source (Thermo Fisher Scientific). Peptides were loaded onto a C18 reversed-phase column (25 cm long, 75 m inner diameter) and separated with a linear gradient of 5-35% buffer B (100% acetonitrile in 0.1% formic acid) at a flow rate of 300 nL/min over 240 min. MS data were acquired using a data-dependent Top15 method dynamically choosing the most abundant precursor ions from the survey scan (400-1400 m/z) using HCD fragmentation. Survey scans were acquired at a resolution of 70,000 at m/z 400. Unassigned precursor ion charge states as well as singly charged species were excluded from fragmentation. The isolation window was set to 3 Da and fragmented with a normalized collision energy of 27. The maximum ion injection times for the survey scan and the MS/MS scans were 20 ms and 60 ms, respectively, and the ion target values were set to 1e6 and 1e5, respectively. Selected sequenced ions were dynamically excluded for 30 seconds. Data were acquired using Xcalibur software (Thermo). 
     Data Processing and Bioinformatic Analysis. 
     Mass spectra were analyzed using MaxQuant software version 1.5.2.8 using the Andromeda search engine. The initial maximum allowed mass deviation was set to 10 ppm for monoisotopic precursor ions and 0.5 Da for MS/MS peaks. Enzyme specificity was set to trypsin, defined as C-terminal to arginine and lysine excluding proline, and a maximum of two missed cleavages were allowed. Carbamidomethylcysteine was set as a fixed modification, and N-terminal acetylation and methionine oxidation as variable modifications. The spectra were searched with the Andromeda search engine against the Human and RSV SWISSPROT sequence database (containing 20,193 human protein entries and 11 RSV protein entries) combined with 248 common contaminants, and concatenated with the reversed versions of all sequences. Protein identification required at least one unique or razor peptide per protein group. Quantification in MaxQuant was performed using the built in XIC-based label-free quantification (LFQ) algorithm (29). The required false discovery rate (FDR) for identification was set to 1% at the peptide and 1% at the protein level, and the minimum required peptide length to 6 amino acids. Contaminants, reverse identification and proteins only identified by site were excluded from further data analysis. The raw data, and database search results are deposited in ProteomeXchange under Project Accession Number PXD005814. For comparative analysis, the LFQ values were log 2-transformed. After filtering (at least 2 valid LFQ values in at least one group), remaining missing LFQ values were imputed from a normal distribution (width: 0.3; down shift: 1.8). Significance analysis of microarrays (SAM) was used to assess the statistical significance of protein abundances using 1% FDR adjustment and a two-fold cutoff. The normalized spectral abundance factor (NSAF) value for each protein was calculated as 
       (NSAF) k =( I/L ) k /Σ i=3   N ( I/L ) i ,
 
     where the total MS intensity (I) of the matching peptides from protein k was divided by the protein length (L) and then by the sum of I/L for all uniquely identified proteins in the dataset. 
     For pairwise comparisons, missing NSAF values for proteins that were only present in either CM or the whole-cell lysate (WCL) were imputed from a normal distribution (width: 0.3; down shift: 1.8). For principal component analysis, unsupervised hierarchical clustering, GO annotation enrichment, and Fisher&#39;s exact tests, we used the Perseus bioinformatics platform. We used Ingenuity Pathways Analysis (IPA) for upstream regulator analysis. Gene set enrichment analysis was performed by quantifying canonical pathway enrichment. Exosome analyses were performed by searching the ExoCarta exosome database. 
     Stable Isotope Dilution (SID)-Selected Reaction Monitoring (SRM)-MS. 
     The SID-SRM-MS assays were developed. The peptides were chemically synthesized incorporating isotopically labeled [ 13 C 6   15 N 4 ] arginine or [ 13 C 6   15 N 2 ] lysine to a 99% isotopic enrichment (Thermo Scientific). The secretome and cellular proteome were digested as described above. The tryptic digests were reconstituted in 30 μL of 5% formic acid/0.01% TFA. An aliquot of 10 μL of diluted stable isotope-labeled standard (SIS) peptides was added to each tryptic digest. These samples were desalted with a ZipTip C18 cartridge; the peptides were eluted with 80% can, dried, reconstituted in 30 μL of 5% formic acid/0.01% TFA, and directly analyzed by liquid chromatography (LC)-SRM-MS using a TSQ Vantage triple quadrupole mass spectrometer equipped with a nanospray source (Thermo Scientific, San Jose, Calif.). Online chromatography was performed using an Eksigent NanoLC-2D HPLC system (AB SCIEX, Dublin, Calif.). An aliquot of 10 μL of each tryptic digest was injected onto a C18 reversed-phase nano-HPLC column (PicoFrit™, 75 μm×10 cm; tip ID 15 m) at a flow rate of 500 nL/min with a 20-min 98% A, followed by a 15-min linear gradient from 2-30% mobile phase B (0.1% formic acid/90% acetonitrile) in mobile phase A (0.1% formic acid). The TSQ Vantage was operated in high-resolution SRM mode with Q1 and Q3 set to 0.2 and 0.7-Da Full Width Half Maximum (FWHM). All acquisition methods used the following parameters: 1800 V ion spray voltage, a 275° C. ion transferring tube temperature, a collision-activated dissociation pressure at 1.5 mTorr, and the S-lens voltage used the values in the S-lens table generated during MS calibration. 
     All SRM data were manually inspected to ensure peak detection and accurate integration. The chromatographic retention time and the relative product ion intensities of the analyte peptides were compared to those of the SIS peptides. The variation of the retention time between the analyte peptides and their SIS counterparts should be within 0.05 min, and no significant differences in the relative product ion intensities of the analyte peptides and SIS peptides were observed. The peak areas in the extract ion chromatography of the native and SIS version of each signature peptide were integrated using Xcalibur® 2.1. The default values for noise percentage and baseline subtraction window were used. The ratios between the peak area of the native and SIS versions of each peptide were calculated. 
     Quantitative Real Time PCR (Q-RT-PCR). 
     For gene expression analyses, 1 μg of RNA was reverse-transcribed using Super Script III in a 20 μL reaction mixture (34). One L of cDNA product was diluted 1:2, and 2 μL of diluted product was amplified in a 20 μL reaction mixture containing 10 μL of SYBR Green Supermix (Bio-Rad) and 0.4 μM each of forward and reverse gene-specific primers. The reaction mixtures were aliquoted into a Bio-Rad 96-well clear PCR plate and the plate sealed with Bio-Rad Microseal B film before insertion into the PCR machine. The plates were denatured for 90 s at 95° C. and then subjected to 40 cycles of 15 s at 94° C., 60 s at 60° C., and 1 min at 72° C. in an iCycler (Bio-Rad). PCR products were subjected to melting curve analysis to assure that a single amplification product was produced. Quantification of relative changes in gene expression was calculated using the ΔΔCt method. Data were expressed as fold change mRNA normalized to cyclophilin or PolB mRNA abundance as indicated as an internal control. 
     RSV Infection in BALB/c Mice. 
     BALB/c mice (Harlan) were inoculated intranasally (in) with 50 μL of pRSV (final inoculum, 10 7  pfu) diluted in PBS under light anesthesia. Twenty-four hours later, the animals were euthanized and their lungs fixed in paraformaldehyde for immunohistochemical analysis. Sections were prepared and stained with H&amp;E or Periodic Acid Schiff (Abcam) stains using standard techniques. 
     Results 
     Analysis Pipeline for Cell Type-Specific Differences in the Epithelial Secretome 
     In the first experiment, we examined the effects of RSV on secreted proteins in hBECs derived from the trachea vs hSAECs, derived from the terminal bronchioles. RSV effectively replicates in both cell types, expressing cytokines, producing infectious virions and syncytia formation. To directly compare the levels of RSV replication, tert-hBECs and tert-hSAECs were infected with sucrose cushion-purified (p)-RSV (MOI=1, 24 h). Cells were lysed and the expression of RSV nucleoprotein (N), matrix protein (M), phosphoprotein (P) and matrix M2-1 (M2-1) determined by LC-MS/MS. The levels of RSV expression for all proteins measured were dramatically elevated in tert-hBECs and tert-hSAECs relative to uninfected cells. Interestingly, RSV protein replication was 4-fold higher in tert-hBECs than in tert-hSAECs. Similar results were observed in the conditioned medium (CM) from each cell type (although the protein abundance was lower due to medium dilution), indicating viral secretion.  FIG. 17  (left panel) shows the differential expression of secreted proteins (top) vs cell lysates (bottom) for hBECS, while  FIG. 17  (right panel) shows the differential expression of secreted proteins in secreted proteins vs lysates for hSAECs. 
     To determine the effects of RSV infection on cell viability, apoptosis and necrosis rates of control and RSV-infected tert-hBECs and tert-hSAECs (MOI=1, 24 h) were measured by flow cytometry. Cellular necrosis was minimal in both cell types in the absence or presence of RSV infection. However, in the absence of infection, tert-hBECs had a higher basal apoptotic rate than did tert-hSAECs (18.8% vs 10.8%). In both cell types, RSV infection reduced the apoptosis rate. The apoptotic rate of tert-hBECs fell from 18.8 to 12.5%, and of tert-hSAECs fell from 10.8% to 7.9%. The data confirms that under these conditions, the cells are viable, and actively replicating and secreting RSV. 
     We next sought to quantify the reproducibility of our label-free proteomics workflow to detect changes in secreted proteins by cell type and in response to RSV infection. Cell culture supernatants from 4 independent biological replicates from tert-hBECs vs tert-SAECs were analyzed in mock-infected cells and 24 h after RSV infection. 1,559 proteins were identified in the supernatants with a false discovery rate (FDR) of &lt;1%, determined by target-decoy database searching. To determine biological reproducibility, pairwise analysis of the log 2-transformed protein abundance was performed. The Pearson correlations (r 2 ) were &gt;0.85, indicating a high degree of concordance (Table I). We noted that across samples, the r 2  was greater for the RSV-induced CM vs control (for control tert-hBECs, the groupwise mean r 2 =0.863±0.008, whereas the RSV-infected tert-hBEC groupwise mean r 2 =0.957±0.005; and for control tert-hSAECs, mean r 2 =0.863±0.01 vs RSV-infected tert-hSAEC mean r 2 =0.936±0.011; both p&lt;0.05 Student&#39;s t-test). These data indicate that the method was reproducible, and that the highly abundant proteins in the RSV-induced CM were more accurately measured. 
     
       
         
           
               
             
               
                 TABLE I 
               
               
                   
               
               
                 Proteins unique to hSAECs. Shown is a list of proteins unique to hSAECs. 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
            
               
                 Q13509 
                 Tubulin beta-3 chain 
                 TUBB3 
               
               
                 Q9Y570 
                 Protein phosphatase methylesterase 1 
                 PPME1 
               
               
                 P07738 
                 Bisphosphoglycerate mutase 
                 BPGM 
               
               
                 P61081 
                 NEDD8-conjugating enzyme Ubc12 
                 UBE2M 
               
               
                 P56211 
                 cAMP-regulated phosphoprotein 19 
                 ARPP19 
               
               
                 Q9BV57 
                 1,2-dihydroxy-3-keto-5-methylthiopentene 
                 ADI1 
               
               
                   
                 dioxygenase 
               
               
                 Q9H8S9 
                 MOB kinase activator 1A; MOB kinase activator 1B 
                 MOB1A; MOB1B 
               
               
                 P50583 
                 Bis(5-nucleosyl)-tetraphosphatase [asymmetrical] 
                 NUDT2 
               
               
                 P99999 
                 Cytochrome c 
                 CYCS 
               
               
                 P42126 
                 Enoyl-CoA delta isomerase 1, mitochondrial 
                 ECI1 
               
               
                 Q9P2F8 
                 Signal-induced proliferation-associated 1-like 
                 SIPA1L2 
               
               
                   
                 protein 2 
               
               
                 A6NDG6 
                 Phosphoglycolate phosphatase 
                 PGP 
               
               
                 Q1KMD3 
                 Heterogeneous nuclear ribonucleoprotein U-like 
                 HNRNPUL2 
               
               
                   
                 protein 2 
               
               
                 Q86TI2 
                 Dipeptidyl peptidase 9 
                 DPP9 
               
               
                 P25325 
                 3-mercaptopyruvate sulfurtransferase 
                 MPST 
               
               
                 O43813 
                 LanC-like protein 1 
                 LANCL1 
               
               
                 P40261 
                 Nicotinamide N-methyltransferase 
                 NNMT 
               
               
                 Q00169 
                 Phosphatidylinositol transfer protein alpha isoform 
                 PITPNA 
               
               
                 P61086 
                 Ubiquitin-conjugating enzyme E2 K 
                 UBE2K 
               
               
                 Q13126 
                 S-methyl-5-thioadenosine phosphorylase 
                 MTAP 
               
               
                 P10768 
                 S-formylglutathione hydrolase 
                 ESD 
               
               
                 P50479 
                 PDZ and LIM domain protein 4 
                 PDLIM4 
               
               
                 P82979 
                 SAP domain-containing ribonucleoprotein 
                 SARNP 
               
               
                 P27144 
                 Adenylate kinase 4, mitochondrial 
                 AK4 
               
               
                 Q9BY32 
                 Inosine triphosphate pyrophosphatase 
                 ITPA 
               
               
                 P48637 
                 Glutathione synthetase 
                 GSS 
               
               
                 Q9GZP4 
                 PITH domain-containing protein 1 
                 PITHD1 
               
               
                 Q9NZD2 
                 Glycolipid transfer protein 
                 GLTP 
               
               
                 Q05397 
                 Focal adhesion kinase 1 
                 PTK2 
               
               
                 P52943 
                 Cysteine-rich protein 2 
                 CRIP2 
               
               
                 P42771 
                 Cyclin-dependent kinase inhibitor 2A, isoforms 
                 CDKN2A; 
               
               
                   
                 1/2/3; Cyclin-dependent kinase 4 inhibitor B 
                 CDKN2B 
               
               
                 P30519 
                 Heme oxygenase 2 
                 HMOX2 
               
               
                 Q9P0L0 
                 Vesicle-associated membrane protein-associated 
                 VAPA 
               
               
                 P21399 
                 Cytoplasmic aconitate hydratase 
                 ACO1 
               
               
                 P09417 
                 Dihydropteridine reductase 
                 QDPR 
               
               
                 P23434 
                 Glycine cleavage system H protein, mitochondrial 
                 GCSH 
               
               
                 P35270 
                 Sepiapterin reductase 
                 SPR 
               
               
                 Q92882 
                 Osteoclast-stimulating factor 1 
                 OSTF1 
               
               
                 O15347 
                 High mobility group protein B3 
                 HMGB3 
               
               
                 Q99798 
                 Aconitate hydratase, mitochondrial 
                 ACO2 
               
               
                 Q9Y2D5 
                 A-kinase anchor protein 2 
                 AKAP2 
               
               
                 P58107 
                 Epiplakin 
                 EPPK1 
               
               
                 Q9NX46 
                 Poly(ADP-ribose) glycohydrolase ARH3 
                 ADPRHL2 
               
               
                 P04181 
                 Ornithine aminotransferase, mitochondrial; Ornithine 
                 OAT 
               
               
                   
                 aminotransferase, hepatic form; Ornithine 
               
               
                   
                 aminotransferase, renal form 
               
               
                 P50452 
                 Serpin B8 
                 SERPINB8 
               
               
                 Q96EK6 
                 Glucosamine 6-phosphate N-acetyltransferase 
                 GNPNAT1 
               
               
                 Q969D9 
                 Thymic stromal lymphopoietin 
                 TSLP 
               
               
                 Q8TEA8 
                 D-tyrosyl-tRNA(Tyr) deacylase 1 
                 DTD1 
               
               
                 Q5JRX3 
                 Presequence protease, mitochondrial 
                 PITRM1 
               
               
                 Q53FA7 
                 Quinone oxidoreductase PIG3 
                 TP53I3 
               
               
                 P54105 
                 Methylosome subunit pICln 
                 CLNS1A 
               
               
                 O75884 
                 Putative hydrolase RBBP9 
                 RBBP9 
               
               
                 O95994 
                 Anterior gradient protein 2 homolog 
                 AGR2 
               
               
                 Q8NBJ7 
                 Sulfatase-modifying factor 2 
                 SUMF2 
               
               
                 P16619 
                 C-C motif chemokine 3-like 1; LD78-beta(3- 
                 CCL3L1 
               
               
                   
                 70); LD78-beta(5-70) 
               
               
                 P52566 
                 Rho GDP-dissociation inhibitor 2 
                 ARHGDIB 
               
               
                 O60749 
                 Sorting nexin-2 
                 SNX2 
               
               
                 P36551 
                 Oxygen-dependent coproporphyrinogen-III 
                 CPOX 
               
               
                   
                 oxidase, mitochondrial 
               
               
                 Q9UFN0 
                 Protein NipSnap homolog 3A 
                 NIPSNAP3A 
               
               
                 Q8WWM9 
                 Cytoglobin 
                 CYGB 
               
               
                 P04179 
                 Superoxide dismutase [Mn], mitochondrial 
                 SOD2 
               
               
                 P67870 
                 Casein kinase II subunit beta 
                 CSNK2B 
               
               
                 O60701 
                 UDP-glucose 6-dehydrogenase 
                 UGDH 
               
               
                 P30084 
                 Enoyl-CoA hydratase, mitochondrial 
                 ECHS1 
               
               
                 P13804 
                 Electron transfer flavoprotein subunit alpha, 
                 ETFA 
               
               
                   
                 mitochondrial 
               
               
                 O15305 
                 Phosphomannomutase 2 
                 PMM2 
               
               
                 O76054 
                 SEC14-like protein 2 
                 SEC14L2 
               
               
                 P49411 
                 Elongation factor Tu, mitochondrial 
                 TUFM 
               
               
                 Q5T2P8 
                 Annexin A8-like protein 1 
                 ANXA8L1 
               
               
                 Q16836 
                 Hydroxyacyl-coenzyme A dehydrogenase, 
                 HADH 
               
               
                   
                 mitochondrial 
               
               
                 Q9Y4K1 
                 Absent in melanoma 1 protein 
                 AIM1 
               
               
                 Q9HD15 
                 Steroid receptor RNA activator 1 
                 SRA1 
               
               
                 Q59GN2 
                 Putative 60S ribosomal protein L39-like 5/39 
                 RPL39P5; RPL39 
               
               
                 O15400 
                 Syntaxin-7 
                 STX7 
               
               
                 P31146 
                 Coronin-1A 
                 CORO1A 
               
               
                 Q13642 
                 Four and a half LIM domains protein 1 
                 FHL1 
               
               
                 Q9H993 
                 UPF0364 protein C6orf211 
                 C6orf211 
               
               
                 Q15149 
                 Plectin 
                 PLEC 
               
               
                 P35754 
                 Glutaredoxin-1 
                 GLRX 
               
               
                 Q01995 
                 Transgelin 
                 TAGLN 
               
               
                 P48745 
                 Protein NOV homolog 
                 NOV 
               
               
                 O00244 
                 Copper transport protein ATOX1 
                 ATOX1 
               
               
                 P26885 
                 Peptidyl-prolyl cis-trans isomerase FKBP2 
                 FKBP2 
               
               
                 P06132 
                 Uroporphyrinogen decarboxylase 
                 UROD 
               
               
                 P37268 
                 Squalene synthase 
                 FDFT1 
               
               
                 Q08257 
                 Quinone oxidoreductase 
                 CRYZ 
               
               
                 Q8NFU3 
                 Thiosulfate sulfurtransferase/rhodanese-like 
                 TSTD1 
               
               
                   
                 domain-containing protein 1 
               
               
                 Q9NQR4 
                 Omega-amidase NIT2 
                 NIT2 
               
               
                 P30838 
                 Aldehyde dehydrogenase, dimeric NADP- 
                 ALDH3A1 
               
               
                   
                 preferring 
               
               
                 P78556 
                 C-C motif chemokine 20; CCL20(1-67); CCL20(1- 
                 CCL20 
               
               
                   
                 64); CCL20(2-70) 
               
               
                 O95394 
                 Phosphoacetylglucosamine mutase 
                 PGM3 
               
               
                 Q9ULC4 
                 Malignant T-cell-amplified sequence 1 
                 MCTS1 
               
               
                 P12532 
                 Creatine kinase U-type, mitochondrial 
                 CKMT1A 
               
               
                 Q6FI81 
                 Anamorsin 
                 CIAPIN1 
               
               
                 P42330 
                 Aldo-keto reductase family 1 member C3 
                 AKR1C3 
               
               
                 Q13011 
                 Delta(3,5)-Delta(2,4)-dienoyl-CoA isomerase, 
                 ECH1 
               
               
                   
                 mitochondrial 
               
               
                 P51572 
                 B-cell receptor-associated protein 31 
                 BCAP31 
               
               
                 O75390 
                 Citrate synthase, mitochondrial 
                 CS 
               
               
                 P30520 
                 Adenylosuccinate synthetase isozyme 2 
                 ADSS 
               
               
                 Q9NQ88 
                 Fructose-2,6-bisphosphatase TIGAR 
                 TIGAR 
               
               
                 Q9H2U2 
                 Inorganic pyrophosphatase 2, mitochondrial 
                 PPA2 
               
               
                 Q15833 
                 Syntaxin-binding protein 2 
                 STXBP2 
               
               
                 P21266 
                 Glutathione S-transferase Mu 3 
                 GSTM3 
               
               
                 O75368 
                 SH3 domain-binding glutamic acid-rich-like protein 
                 SH3BGRL 
               
               
                 P43490 
                 Nicotinamide phosphoribosyltransferase 
                 NAMPT 
               
               
                 Q8WUP2 
                 Filamin-binding LIM protein 1 
                 FBLIM1 
               
               
                 P19623 
                 Spermidine synthase 
                 SRM 
               
               
                 Q9HAV7 
                 GrpE protein homolog 1, mitochondrial 
                 GRPEL1 
               
               
                 P29218 
                 Inositol monophosphatase 1 
                 IMPA1 
               
               
                 P34897 
                 Serine hydroxymethyltransferase, mitochondrial 
                 SHMT2 
               
               
                 Q9BSJ8 
                 Extended synaptotagmin-1 
                 ESYT1 
               
               
                 P23368 
                 NAD-dependent malic enzyme, mitochondrial 
                 ME2 
               
               
                 P42704 
                 Leucine-rich PPR motif-containing protein, 
                 LRPPRC 
               
               
                   
                 mitochondrial 
               
               
                 O15231 
                 Zinc finger protein 185 
                 ZNF185 
               
               
                 Q13630 
                 GDP-L-fucose synthase 
                 TSTA3 
               
               
                 O00515 
                 Ladinin-1 
                 LAD1 
               
               
                   
               
            
           
         
       
     
     Secretome Proteins are a Distinct Population of Proteins from that Produced by Cellular Lysis 
     To further extend our findings that the proteins in the secretome are not derived from cellular lysis, cellular lysates were prepared from the same experiment and analyzed in parallel. 1,929 unique proteins were quantified from the tert-hBEC and tert-hSAEC whole-cell lysates (WCL). The global protein expression patterns in the CM and WCLs were first examined using principal component analysis (PCA). In this analysis, 91.6% of the variability was accounted for in the first two dimensions, indicating a robust analysis. The WCLs from control or RSV-infected cells clustered by cell type and presence of RSV infection, indicating that biological replicates were consistent. We noted that the control tert-hBEC WCL formed a distinct cluster from that of the tert-hSAEC WCLs, separated by the second principal component dimension. The RSV-infected tert-hBEC WCLs moved in the second dimension to form a cluster that overlapped with both control and RSV-infected tert-hSAEC WCLs. Both the control secretomes of tert-hBECs and tert-hSAECs clustered together, widely separated in the first dimension from the WCL clusters. Upon RSV infection, both the tert-hBEC and tert-hSAEC secretomes migrated up in the second dimension and down in the first dimension. Together, these analyses indicate that the secretome represented a distinct protein set from the cellular lysate, and that RSV induced significant changes in its composition. 
     460 proteins were present only in the secretome, 885 proteins were unique to the cellular proteome, and 1,044 proteins were present in both datasets. To further confirm that these protein sets were distinct, we conducted unbiased genome ontology cellular component (GOCC) enrichment analysis of the proteins present only in the CM dataset. This analysis indicated that the secretome was enriched with proteins derived from the extracellular region part (205 out of 460 proteins), while the cytoplasmic and mitochondrial proteins were depleted (Fisher Exact test, Benjamini-Hochberg FDR 0.1%; data not shown). By contrast, proteins unique to the WCL were enriched with mitochondrial, ribosomal, and nuclear proteins, and proteins in the extracellular region were depleted. 
     To confirm that the secreted proteins were independent of cellular lysis in a more quantitative manner, we used the normalized spectral abundance factor (NSAF) method to confirm the enrichment of the proteins in CM and WCL. In spectral counting, larger proteins usually generate more peptides and therefore more spectral counts than smaller proteins. Therefore, the number of spectral counts for each protein is first divided by the protein length, which defines the spectral abundance factor (SAF). Furthermore, to accurately account for sample-to-sample variation, individual SAF values are normalized by dividing by the sum of all SAFs for proteins identified in the sample, resulting in the NSAF value. In this manner, NSAF values are standardized across distinct samples, allowing direct comparisons of the relative protein abundance across samples. 
     We then conducted a pairwise comparison of NSAF values of proteins in the RSV CM to that of the WCL in RSV-infected tert-hBECs. A two-sample t-test was used to assess the statistical significance of protein enrichment in the RSV CM to that of the WCL. For tert-hBECs, proteins enriched in the CM (indicated in red, Benjamini-Hochberg FDR 1%) included macrophage inhibitory factor (MIF-1), macrophage migration CXCL-10, interferon-stimulated gene-15, high mobility group box (HMGB) 1/2, interferon-induced protein with tetratricopeptide repeats (IFIT)-3, IFN lambda 2, and others. All of these proteins are well-characterized, secreted proteins with defined roles in innate immunity. The abundance of these proteins was depleted in the WCLs. Conversely, we identified high-abundance intracellular proteins in the cell extract (indicated in blue, Benjamini-Hochberg FDR 1%) that were depleted in the CM, including histones H2HAC/1H2BM, mitochondrial single-stranded DNA-binding protein (SSBP)-1, heat shock 10 kDa protein 1 (HSPE1), and actin gamma (ACTG)-1. 
     Similar observations were made in the comparison of high-abundance proteins in the tert-hSAEC CM and WCLs. Although the proteins comprising the tert-hBEC and tert-hSAEC CM were similar, we noted that CCL5 was in high abundance in the tert-hBEC and much lower in the tert-hSAEC CM. Conversely, CCL20 and IL-6 were much more highly abundant in the tert-hSAEC secretome than in the tert-hBEC secretome. Together these data indicate that the CM samples represent a distinct proteome profile vs that in the WCL. We will refer to this population of proteins as the “secretome” in the remainder of this study. 
     Biological Functions of the RSV-Induced Secretome 
     To further support the conclusion that the secretome and cell lysates represent distinct protein pools, we conducted unbiased genome ontology cellular component (GOCC) enrichment. The top-ranked cellular components for the RSV-induced secretome of tert-hBECs (indicated in red) were “extracellular matrix,” “extracellular space” and “extracellular organelle,” indicating that this sample was enriched in extracellular proteins relative to the reference human proteome. The cellular components corresponding to “cell part,” “macromolecular complexes,” and “ribonucleoprotein complexes” were depleted in the secretome. By contrast, in the tert-hBEC WCLs, the GOCCs “nucleolar ribonucleoprotein complex,” “NADH dehydrogenase complex,” and “ribosomal complex” were the top-ranked components. Similarly, the “proteinaceous extracellular matrix” and “extracellular matrix” were the two most significantly depleted cellular components (blue bars,  FIG. 2F ). These data further support that the proteins identified in the secretome represent a distinct population from the intracellular proteome in the WCL. There were similar findings for tert-hSAECs, with extracellular proteins being the most highly enriched proteins in the hSAEC secretome GOCC analysis. We noted that the cellular component terms for the hBEC and hSAEC secretomes were almost identical. 
     RSV Induces Exosome Production in a Cell Type-Dependent Pattern 
     We noted that the majority of 1,044 proteins that were present in both the tert-hBEC and tert-hSAEC secretomes were cytosolic proteins. These cytosolic proteins may be secreted via unconventional protein secretory pathways, perhaps mediated by Golgi or endosomal export mechanisms. To this point, we found that 65 of these common proteins, including heat shock cognate 71 kDa protein (HSPA8), glyceraldehyde-3-phosphate GAPDH), and annexin A2 (ANXA2) are prominent exosomal proteins. To provide some insight into whether endosomal transport was contributing to the RSV-induced secretome, we isolated and quantified exosomal proteins from control and RSV-infected tert-hBECs and tert-hSAECs. 
     Ultracentrifuge-purified exosomes manifested 112.8±2.0 nm in size by dynamic light scattering, and exhibited a characteristic membrane composition in TEM ( FIG. 18 ). From this fraction, 937 exosomal proteins were identified; of these, 564 proteins were identified in the secretome (373 proteins unique to the exosomal fraction were below the limit of detection and not observed in the secretome analysis). The 937 proteins were subjected to GOCC. Significantly enriched cellular components included lysosomal, vacuolar, and endoplasmic reticular. Out of 937 identified exosome proteins, 853 were quantified across the experimental groups. Pairwise comparison by cell type and presence of RSV infection was accomplished using Student&#39;s t-test, as shown in a Volcano plot, where the Log 2 fold change is plotted vs the Log 10-transformed p value. RSV infection caused up-regulation of 220 tert-hSAEC and 241 tert-hBEC exosomal proteins; and downregulation of 146 tert-hSAEC and 223 tert-hBEC exosomal proteins (FDR&lt;0.05). The protein contents in the exosome also display cell type differences. In the basal state, 31 proteins were more abundant in the tert-hSAEC exosome fraction, while 60 proteins were more abundant in the tert-hBEC exosome fraction (FDR&lt;0.05). After RSV infection, 273 exosome proteins were different by cell type, with 134 proteins more abundant in RSV-infected tert-hSAEC exosomes and 139 proteins more abundant in RSV-infected tert-hBEC exosomes (FDR&lt;0.05). 
     We applied a statistical filter using a p value (Student&#39;s t-test with Benjamini-Hochberg FDR correction of &lt;0.05) and an expression filter of ±5-fold change between control vs RSV-infected NSAF to identify the most highly differentially expressed exosomal proteins. The expression patterns were next compared by hierarchical clustering. These data clearly indicate that the exosomal proteins are different by cell type, and modified by the presence of RSV infection. Of the 559 proteins in the secretome not directly found in the exosomal fraction, 80 proteins have identifiable signal peptides, with the remainder being enriched in lysosomal and vacuolar proteins. These findings suggest that the RSV-induced epithelial secretome is mediated primarily by exosomal protein release, with a smaller fraction due to lysosome- or vacuole-mediated export, and a small fraction by classical protein secretion. 
     Differential Expression Patterns by Cell Type 
     We next examined the differential expression patterns of secretome by cell type. Statistical analysis of microarray (SAM) was applied to identify differentially expressed proteins using 1% false discovery rate (FDR). SAM identified 71 proteins distinct in the control secretomes from tert-hBECs vs tert-hSAECs. Of these, 61 were upregulated in the tert-hSAEC secretome. Similarly, 131 proteins showed differential expression in the RSV-induced secretomes from tert-hBECs and tert-hSAECS. Of these, 65 were upregulated in hSAECs. 
     The differentially expressed proteins were subjected to 2-dimensional hierarchical clustering. Hierarchical clustering groups proteins whose expression patterns are most similar across cell type and treatment condition. The samples are also clustered by the patterns of proteins. In this analysis, the treatment groups co-clustered in the vertical dimension, consistent with the findings in PCA analysis that the replicates from each cell type are highly similar. By inspection of the proteins in the rows, 5 distinct patterns of protein expression emerged. One group represented proteins abundant in control tert-hBECs whose expression is inhibited in response to RSV (not expressed by tert-hSAECs). One group represented proteins expressed by tert-hSAECs whose abundance is decreased in response to RSV. One group represented proteins only expressed by RSV-infected tert-hSAECs. One group represented proteins induced by RSV that are common to both cell types. One group represented proteins induced by tert-hBECs but not tert-hSAECs. One of these groups contained a number of immunologically significant proteins, including CXCL1, IL-6 and CCL20. These data suggest that RSV induces cell-type differences in the secretion of immunologically significant cytokines. Collectively, our analysis pipeline developed using tert-immortalized human epithelial cells, enables the reliable analysis of epithelial secretomes to understand differences by cell type and RSV-induced expression patterns. 
     Primary Epithelial Cell Secretomes 
     We next applied our analysis pipeline to primary isolates of human BECs (phBECs) and primary isolates of SAECs (phSAECs). To control for donor effects, the analysis was conducted on three independent donors; two biological replicates were analyzed for each. As validation of the distinct phenotypes, immunofluorescence microscopy was conducted to examine differences in epithelial cytokeratin expression. phBECs express cytokeratins 7 and 19; by contrast, hSAECs have low (or undetectable) cytokeratin 7 and strong cytokeratin 19 expression. Both cell types support active RSV replication and secretion of virus. 
     Secretome fractions were prepared from control and RSV-infected primary cells. We identified 2,376 proteins with FDR 1%. SAM analysis identified 577 proteins in the secretome from control (uninfected) cells whose expression varied by cell type, and 966 proteins in the secretome from RSV-infected cells whose expression varied by cell type (FDR of 1%). To focus on the most robust differentially expressed proteins, we filtered proteins that showed a 5-fold expression change or greater; this resulted in 492 of the most highly significant and induced proteins. This filtered dataset was subjected to 2-dimensional hierarchical clustering, where each column represents a sample and each row represents an individual protein&#39;s abundance. We observed that each sample co-clustered with its replicate, as well as by being grouped by cell type and RSV treatment. The row-wise clustering of proteins produced a pattern highly similar to that observed in the Tert-immortalized hBECs and hSAECs; in this example, cluster 2 represents 11 proteins upregulated by RSV infection in phBECs; cluster 3 represents 116 proteins upregulated by RSV infection in phSAECs; and cluster 4 contains 203 proteins induced by both cell types (Table II). 
     
       
         
           
               
             
               
                 TABLE II 
               
             
            
               
                   
               
               
                 Proteins upregulated in RSV infected hSAECs. 
               
            
           
           
               
               
               
            
               
                 Protein ID 
                 Name 
                 Enrichment vs control 
               
               
                   
               
            
           
           
               
               
               
            
               
                 P05187 
                 ALPP PLAP 
                 5.9623 
               
               
                 Q02878 
                 RPL6 TXREB1 
                 5.916594 
               
               
                 P47914 
                 RPL29 
                 5.902925 
               
               
                 P62280 
                 RPS11 
                 5.819751 
               
               
                 P42677 
                 RPS27 MPS1 
                 5.54576 
               
               
                 P42766 
                 RPL35 
                 5.380875 
               
               
                 P67809 
                 YBX1 NSEP1 YB1 
                 5.363283 
               
               
                 P29034 
                 S100A2 S100L 
                 5.029694 
               
               
                 P18621 
                 RPL17 
                 5.021404 
               
               
                 P62888 
                 RPL30 
                 4.961142 
               
               
                 P62851 
                 RPS25 
                 4.758911 
               
               
                 P0CW22 
                 RPS17L 
                 4.75418 
               
               
                 P62841 
                 RPS15 RIG 
                 4.634076 
               
               
                 P61221 
                 ABCE1 RLI 
                 4.593896 
               
               
                 P11802 
                 CDK4 
                 4.565168 
               
               
                 P80723 
                 BASP1 NAP22 
                 4.535751 
               
               
                 P10321 
                 HLA-C HLAC 
                 4.533401 
               
               
                 P27816 
                 MAP4 
                 4.450186 
               
               
                 P27708 
                 CAD 
                 4.422149 
               
               
                 Q07020 
                 RPL18 
                 4.402696 
               
               
                 P23921 
                 RRM1 RR1 
                 4.383801 
               
               
                 P07910 
                 HNRNPC HNRPC 
                 4.376354 
               
               
                 P18124 
                 RPL7 
                 4.340407 
               
               
                 P84243 
                 H3F3A H3.3A H3F3 PP781; 
                 4.315348 
               
               
                   
                 H3F3B H3.3B 
               
               
                 P62241 
                 RPS8 OK/SW-cl.83 
                 4.303235 
               
               
                 P49327 
                 FASN FAS 
                 4.301689 
               
               
                 P29692 
                 EEF1D EF1D 
                 4.269896 
               
               
                 Q5T4S7 
                 UBR4 KIAA0462 
                 4.205561 
               
               
                 P05787 
                 KRT8 CYK8 
                 4.16108 
               
               
                 P08727 
                 KRT19 
                 4.109557 
               
               
                 P06748 
                 NPM1 NPM 
                 4.069667 
               
               
                 P23246 
                 SFPQ PSF 
                 3.967895 
               
               
                 Q9Y3U8 
                 RPL36 
                 3.910983 
               
               
                 P36578 
                 RPL4 RPL1 
                 3.846813 
               
               
                 P26373 
                 RPL13 BBC1 OK/SW-cl.46 
                 3.834861 
               
               
                 Q03135 
                 CAV1 CAV 
                 3.834401 
               
               
                 Q8NE71 
                 ABCF1 ABC50 
                 3.832577 
               
               
                 O14879 
                 IFIT3 CIG-49 IFI60 IFIT4 ISG60 
                 3.819192 
               
               
                 P62917 
                 RPL8 
                 3.806039 
               
               
                 Q9NZB2 
                 FAM120A C9orf10 KIAA0183 
                 3.77524 
               
               
                   
                 OSSA 
               
               
                 Q13751 
                 LAMB3 LAMNB1 
                 3.772181 
               
               
                 P02545 
                 LMNA LMN1 
                 3.770924 
               
               
                 P35579 
                 MYH9 
                 3.736661 
               
               
                 Q1KMD3 
                 HNRNPUL2 
                 3.661 
               
               
                 P62081 
                 RPS7 
                 3.638772 
               
               
                 P46778 
                 RPL21 
                 3.614243 
               
               
                 P11586 
                 MTHFD1 
                 3.606673 
               
               
                 P78527 
                 PRKDC HYRC HYRC1 
                 3.572419 
               
               
                 P62753 
                 RPS6 OK/SW-cl.2 
                 3.554307 
               
               
                 Q04637 
                 EIF4G1 EIF4F EIF4G EIF4GI 
                 3.551725 
               
               
                 P61254 
                 RPL26 
                 3.515504 
               
               
                 Q14764 
                 MVP LRP 
                 3.472228 
               
               
                 P39023 
                 RPL3 OK/SW-cl.32 
                 3.470414 
               
               
                 P38646 
                 HSPA9 
                 3.457434 
               
               
                 Q13630 
                 TSTA3 SDR4E1 
                 3.441326 
               
               
                 P61353 
                 RPL27 
                 3.425266 
               
               
                 P32969 
                 RPL9 OK/SW-cl.103; 
                 3.413274 
               
               
                 Q969Q0 
                 RPL36AL 
                 3.359976 
               
               
                 P14868 
                 DARS PIG40 
                 3.344514 
               
               
                 O15027 
                 SEC16A 
                 3.32998 
               
               
                 Q92896 
                 GLG1 
                 3.320409 
               
               
                 Q14258 
                 TRIM25 
                 3.317392 
               
               
                 P62750 
                 RPL23A 
                 3.289345 
               
               
                 Q02543 
                 RPL18A 
                 3.281097 
               
               
                 P84098 
                 RPL19 
                 3.267736 
               
               
                 P29966 
                 MARCKS MACS PRKCSL 
                 3.201019 
               
               
                 Q9P2J5 
                 LARS KIAA1352 
                 3.172232 
               
               
                 P50914 
                 RPL14 
                 3.136532 
               
               
                 P09914 
                 IFIT1 
                 3.109962 
               
               
                 P05387 
                 RPLP2 
                 3.083298 
               
               
                 Q7L5D6 
                 GET4 
                 3.060109 
               
               
                 P62424 
                 RPL7A SURF-3 SURF3 
                 3.051523 
               
               
                 Q00839 
                 HNRNPU 
                 3.042754 
               
               
                 P83731 
                 RPL24 
                 3.026573 
               
               
                 Q8WX93 
                 PALLD 
                 3.010279 
               
               
                 P15924 
                 DSP 
                 2.933567 
               
               
                 P49207 
                 RPL34 
                 2.925651 
               
               
                 P31689 
                 DNAJA1 
                 2.917788 
               
               
                 P46779 
                 RPL28 
                 2.913665 
               
               
                 O75369 
                 FLNB 
                 2.872175 
               
               
                 P61313 
                 RPL15 
                 2.856303 
               
               
                 P62913 
                 RPL11 
                 2.853224 
               
               
                 P12268 
                 IMPDH2 
                 2.818721 
               
               
                 P62899 
                 RPL31 
                 2.812293 
               
               
                 P27635 
                 RPL10 
                 2.812172 
               
               
                 Q7L2H7 
                 EIF3M 
                 2.810656 
               
               
                 O95232 
                 LUC7L3 
                 2.738709 
               
               
                 P62701 
                 RPS4X 
                 2.726098 
               
               
                 O15427 
                 SLC16A3 MCT4 
                 2.723415 
               
               
                 P16070 
                 CD44 
                 2.708791 
               
               
                 P01891 
                 HLA-A 
                 2.704322 
               
               
                 Q6UXN9 
                 WDR82 
                 2.696573 
               
               
                 O00571 
                 DDX3X 
                 2.686682 
               
               
                 P49411 
                 TUFM 
                 2.65141 
               
               
                 Q13753 
                 LAMC2 
                 2.630439 
               
               
                 Q7Z2W4 
                 ZC3HAV1 
                 2.590558 
               
               
                 P46776 
                 RPL27A 
                 2.564557 
               
               
                 P62906 
                 RPL10A NEDD6 
                 2.560694 
               
               
                 P62263 
                 RPS14 PRO2640 
                 2.547316 
               
               
                 P40429 
                 RPL13A 
                 2.508743 
               
               
                 P35268 
                 RPL22 
                 2.497353 
               
               
                 Q04695 
                 KRT17 
                 2.470875 
               
               
                 P30484 
                 HLA-R HLAB 
                 2.460592 
               
               
                 Q12906 
                 ILF3 
                 2.454803 
               
               
                 Q9Y6G9 
                 DYNC1LI1 DNCLI1 
                 2.437955 
               
               
                 P84103 
                 SRSF3 
                 2.425323 
               
               
                 P22102 
                 GART 
                 2.389263 
               
               
                 P05388 
                 RPLP0 
                 2.367745 
               
               
                 P15559 
                 NQO1 
                 2.349192 
               
               
                 Q13347 
                 EIF3I 
                 2.336395 
               
               
                 P46782 
                 RPS5 
                 2.331808 
               
               
                 O43143 
                 DHX15 
                 2.321755 
               
               
                 Q969P0 
                 IGSF8 
                 2.296126 
               
               
                 O60701 
                 UGDH 
                 2.282827 
               
               
                 Q08211 
                 DHX9 
                 2.278905 
               
               
                 Q13451 
                 FKBP5 
                 2.264556 
               
               
                 Q10471 
                 GALNT2 
                 2.262035 
               
               
                 Q9BXJ9 
                 NAA15 
                 2.258991 
               
               
                 Q16787 
                 LAMA3 
                 2.223071 
               
               
                 Q13501 
                 SQSTM1 
                 2.217754 
               
               
                 P62269 
                 RPS18 
                 2.191759 
               
               
                 P02786 
                 TFRC 
                 2.181157 
               
               
                 P17987 
                 TCP1 
                 2.158966 
               
               
                 Q99729 
                 HNRNPAB 
                 2.084764 
               
               
                 Q07955 
                 SRSF1 ASF 
                 2.071358 
               
               
                 P35527 
                 KRT9 
                 2.041417 
               
               
                 Q01650 
                 SLC7A5 
                 2.035409 
               
               
                 Q16643 
                 DBN1 
                 2.033986 
               
               
                 Q99613 
                 EIF3C 
                 2.030562 
               
               
                 P15170 
                 GSPT1 ERF3A 
                 2.026143 
               
               
                 P62244 
                 RPS15A 
                 1.982094 
               
               
                 P62314 
                 SNRPD1 
                 1.981879 
               
               
                 P62910 
                 RPL32 PP9932 
                 1.956094 
               
               
                 P62249 
                 RPS16 
                 1.953426 
               
               
                 P54136 
                 RARS 
                 1.937232 
               
               
                 Q13045 
                 FLII FLIL 
                 1.930296 
               
               
                 Q7Z6Z7 
                 HUWE1 
                 1.928768 
               
               
                 O43795 
                 MYO1B 
                 1.92866 
               
               
                 Q9H3U1 
                 UNC45A SMAP1 
                 1.886301 
               
               
                 O95084 
                 PRSS23 
                 1.875822 
               
               
                 Q00341 
                 HDLBP 
                 1.868465 
               
               
                 Q6NZI2 
                 PTRF 
                 1.846114 
               
               
                 P38159 
                 RBMX 
                 1.844283 
               
               
                 P30050 
                 RPL12 
                 1.843198 
               
               
                 P23229 
                 ITGA6 
                 1.839993 
               
               
                 P05121 
                 SERPINE1 
                 1.819857 
               
               
                 P62277 
                 RPS13 
                 1.801165 
               
               
                 Q16831 
                 UPP1 UP 
                 1.766436 
               
               
                 O14828 
                 SCAMP3 
                 1.757245 
               
               
                 O00567 
                 NOP56 
                 1.750694 
               
               
                 P46781 
                 RPS9 
                 1.733911 
               
               
                 Q9UQ80 
                 PA2G4 
                 1.708888 
               
               
                 P61247 
                 RPS3A 
                 1.695866 
               
               
                 P31943 
                 HNRNPH1 
                 1.694482 
               
               
                 P08195 
                 SLC3A2 
                 1.661627 
               
               
                 Q9Y265 
                 RUVBL1 
                 1.655713 
               
               
                 P05386 
                 RPLP1 
                 1.653083 
               
               
                 O95819 
                 MAP4K4 
                 1.650489 
               
               
                 Q96FJ2 
                 DYNLL2 
                 1.646425 
               
               
                 Q08J23 
                 NSUN2 
                 1.642181 
               
               
                 P62829 
                 RPL23 
                 1.63921 
               
               
                 Q16630 
                 CPSF6 
                 1.631618 
               
               
                 P63173 
                 RPL38 
                 1.630901 
               
               
                 P62847 
                 RPS24 
                 1.627244 
               
               
                 Q29963 
                 HLA-C HLAC 
                 1.622203 
               
               
                 P55263 
                 ADK 
                 1.605915 
               
               
                 P30838 
                 ALDH3A1 
                 1.593838 
               
               
                 P47895 
                 ALDH1A3 
                 1.587489 
               
               
                 P53396 
                 ACLY 
                 1.557952 
               
               
                 Q99880 
                 HIST1H2BL 
                 1.552392 
               
               
                 Q15435 
                 PPP1R7 
                 1.551719 
               
               
                 P62805 
                 HIST1H4A 
                 1.54406 
               
               
                 P51991 
                 HNRNPA3 
                 1.541353 
               
               
                 Q9NR30 
                 DDX21 
                 1.533667 
               
               
                 Q9Y230 
                 RUVBL2 
                 1.526808 
               
               
                 Q14204 
                 DYNC1H1 
                 1.496601 
               
               
                 Q15149 
                 PLEC PLEC1 
                 1.483699 
               
               
                 Q92841 
                 DDX17 
                 1.471951 
               
               
                 P62854 
                 RPS26 
                 1.468868 
               
               
                 P07437 
                 TUBB 
                 1.463055 
               
               
                 P46940 
                 IQGAP1 
                 1.445934 
               
               
                 P46783 
                 RPS10 
                 1.421238 
               
               
                 P68371 
                 TUBB4B 
                 1.413509 
               
               
                 Q9Y263 
                 PLAA 
                 1.388859 
               
               
                 P13010 
                 XRCC5 
                 1.388359 
               
               
                 O76021 
                 RSL1D1 
                 1.381233 
               
               
                 P63244 
                 GNB2L1 
                 1.361151 
               
               
                 O15371 
                 EIF3D 
                 1.346582 
               
               
                 P26006 
                 ITGA3 
                 1.33307 
               
               
                 P07203 
                 GPX1 
                 1.331746 
               
               
                 Q92888 
                 ARHGEF1 
                 1.324795 
               
               
                 P22234 
                 PAICS 
                 1.320945 
               
               
                 P15880 
                 RPS2 
                 1.314672 
               
               
                 Q14152 
                 EIF3A 
                 1.296245 
               
               
                 O60884 
                 DNAJA2 
                 1.289154 
               
               
                 P04264 
                 KRT1 KRTA 
                 1.288633 
               
               
                 Q9HCY8 
                 S100A14 
                 1.280084 
               
               
                 O94776 
                 MTA2 
                 1.266098 
               
               
                 P23396 
                 RPS3 
                 1.240189 
               
               
                 Q13409 
                 DYNC1I2 
                 1.237869 
               
               
                 P48643 
                 CCT5 
                 1.23081 
               
               
                 P08865 
                 RPSA 
                 1.226981 
               
               
                 P46379 
                 BAG6 
                 1.224478 
               
               
                 P13645 
                 KRT10 
                 1.181838 
               
               
                 P07814 
                 EPRS 
                 1.17945 
               
               
                 P34897 
                 SHMT2 
                 1.17018 
               
               
                 Q13310 
                 PABPC4 
                 1.169041 
               
               
                 P60228 
                 EIF3E 
                 1.164251 
               
               
                 Q93008 
                 USP9X 
                 1.139412 
               
               
                 P60660 
                 MYL6 
                 1.138793 
               
               
                 P19105 
                 MYL12A 
                 1.134988 
               
               
                 P47897 
                 QARS 
                 1.132772 
               
               
                 Q92973 
                 TNPO1 
                 1.115839 
               
               
                 P13489 
                 RNH1 
                 1.112878 
               
               
                 Q92900 
                 UPF1 
                 1.111604 
               
               
                 Q9BUF5 
                 TUBB6 
                 1.109345 
               
               
                 P02533 
                 KRT14 
                 1.088403 
               
               
                 Q16629 
                 SRSF7 
                 1.084932 
               
               
                 P46777 
                 RPL5 
                 1.072118 
               
               
                 Q13085 
                 ACACA 
                 1.060328 
               
               
                 Q16881 
                 TXNRD1 
                 1.04443 
               
               
                 P50990 
                 CCT8 
                 1.041376 
               
               
                 P26640 
                 VARS 
                 1.02682 
               
               
                 P09913 
                 IFIT2 
                 1.024306 
               
               
                 P13639 
                 EEF2 
                 1.01451 
               
               
                 P35908 
                 KRT2 
                 1.006343 
               
               
                 P68366 
                 TUBA4A 
                 1.002294 
               
               
                 P39019 
                 RPS19 
                 1.001507 
               
               
                   
               
            
           
         
       
     
     Independent Confirmation of Differential Secretion Patterns 
     To validate the differentially expressed protein patterns, we independently quantified their expression using SID-SRM-MS. The results are shown in  FIG. 19 . This method is a ‘targeted’ MS approach for the detection and accurate quantification of proteins in a complex background where signature proteotypic peptides unique to the protein of interest are monitored in a high mass accuracy mass spectrometer. Because the peptide fragments are then subjected to fragmentation, the assay provides structural specificity and therefore is the most accurate approach available for direct quantification of target proteins in a complex mixture. SRM assays were developed for the measurement of 15 proteins. These assays confirmed the constitutive cell type-specific expression of fibronectin (FN1), and the RSV-induced expression of guanine nucleotide-binding protein (GNAL2), annexin (ANA)-X2, ras oncogene (RAB)-7A, aldolase (ALDO)-A, heat shock protein (HSP)-90, vimentin (VIM), IL-6, integrin alpha 3 (ITGA3), caveolin (CAV)-1 and IFIT-1/2/3 by phSAECs. These data indicated that RSV induces differential expression of proteins by cell type. 
     Biological Functions of Secreted Proteins 
     To gain further understanding of RSV-inducible proteins, we analyzed the clusters by GO biological function and Gene Set Enrichment Analysis (GSEA), primarily focusing on clusters 2, 3 and 4. The 11 proteins in cluster 2 were too limited to identify extensive enriched GO categories. Relative to the human proteome, cluster 2 was depleted in the GO category for metabolic process. GSEA showed enrichment for extrinsic prothrombin pathway and fibrinolysis pathway, predominantly determined by the presence of fibrinogen. The 116 proteins in cluster 3, uniquely expressed by RSV-infected hSAECs, showed enrichment for metabolic processes (organic acid, cellular ketone, and small molecule) relative to the human proteome, and depletion in RNA processing. GSEA identified enrichment of canonical pathways for glycoxylate, carbonyl, porphyrin and amino acid metabolism, and oxidative reduction. This analysis suggests that phSAECs secrete proteins controlling nucleotide-sugar bioenergetic processes in response to RSV. 
     The 203 proteins secreted by both epithelial cell types were analyzed in the same manner. This analysis identified the most GO functions numerically, many of which could be collapsed into mRNA processing (splicing, catabolism, ribonuclease complex assembly), DNA cell cycle regulation and others. GSEA indicated enrichment in mRNA destabilization, Wnt signaling, HIV factor interactions and mRNA interaction/metabolism. 
     Upstream Factor Analysis of Proteins Unique to hSAECs 
     To obtain further insights into the differentially regulated proteins, we subjected all proteins showing differential expression to IPA upstream regulator analysis. Upstream regulator analysis compares the known effect (transcriptional activation or repression) of a transcriptional regulator on its target genes to the observed changes in protein abundance. In phBECs, the epithelium-specific ets homologous factor (EHF) was predicted to be more upregulated and responsible for regulating MUC1, serum amyloid A2 and kallikrein-related peptidase (KLK-6/7). In phSAECs, the NFkB transcription factor was predicted to be activated to a greater degree in response to RSV infection than in hBECs. The NFkB network is responsible for regulating TSLP, CCL20, BMP2, MMP3 and SOD2. 
     Secretion of Th2-Differentiating and Mucin-Inducing Cytokines 
     Our protein-level analysis of the proteins unique to hSAECs identified three proteins highly relevant to the pathogenesis of RSV LRTI-TSLP, CCL20, and CCL3-L1. See  FIG. 20 . These proteins contain signal peptide sequences and are found in the free (non-exosomal fraction). TSLP is produced by RSV-infected airway epithelium and promotes Th2 differentiation by inducing the maturation of antigen-presenting dendritic cells. CCL20 is a potent inducer of epithelial mucin production, Th17 lymphocyte and dendritic cell chemotaxis that promotes formation of mucosal lymphoid tissue formation and plays an important role in the pathology of RSV-induced lung inflammation. Chemokine (C—C motif) ligand 3-like 1 (CCL3-L1) is chemotactic for monocytes and lymphocytes, and interacts with CCR5, a receptor linked to RSV LRTI. 
     We therefore selected these three immunologically important proteins previously implicated in the pathogenesis of RSV LRTI for validation experiments. To independently measure their differential expression by RSV infection and cell type, we developed and applied highly specific SID-SRM-MS assays to measure target protein abundance in the phBEC and phSAEC secretomes in the presence or absence of RSV infection. We were able to detect a 10-fold increase in CCL20, TSLP and CCL3-L1 expression in RSV-infected phSAECs relative to uninfected controls. By contrast, RSV-infected phBECs showed only 2-fold induction of each chemokine, and at much lower amounts than that in phSAECs. The presence or absence of the BSA/growth factor supplements in the cell culture medium did not affect the RSV-induced cell-type differences in the secretion of CCL20, TSLP and IL-6. 
     phSAEC-Secreted CCL20 is a Biologically Active Mucin Inducer 
     Although mucins constitute an important arm of the innate immune response via their ability to trap microorganisms, mucins also play an important role in the pathogenesis of airway obstruction in RSV LRTI. As described earlier, mucous plugging of the small airways is an important mechanism for atelectasis in bronchiolitis, producing ventilation-perfusion mismatching and hypoxia. To determine whether the RSV-induced CCL20 production was at levels sufficient for biological activity, we first evaluated whether phBECs express the CCR6 receptor CCR6 mRNA expression by Q-RT-PCR. Both cell types express CCR6 in uninfected and infected conditions. We next stimulated naïve phBECs with either recombinant CCL20 or CM from RSV-infected phSAECs and assayed for MUC5A mRNA expression by Q-RT-PCR. Recombinant CCL20 induced a reproducible 8-fold induction of MUC5AC mRNA expression relative to control, which was lost at higher concentrations. RSV-CM produced a similar 8-fold induction of MUC5A. Both of these activities were inhibited by the addition of neutralizing CCL20 Ab; pre-immune IgG had no effect. Together these data indicate that RSV-infected phSAECs produce biologically active CCL20 that stimulates mucin production. 
     Confirmation of Enhanced CCL20 in Lower Airway Epithelial Cells In Vivo 
     Our quantitative in vitro proteomic studies suggest that lower airway epithelial cells exhibit enhanced CCL20 secretion upon RSV infection. To confirm this, we examined CCL20 expression in a BALB/c mouse model of acute RSV infection established in our laboratories. Immunofluorescence (IF) assays were performed on proximal and distal airways in control and RSV-infected mice. In the absence of primary antibody, no fluorescence was observed. In proximal airways, IF was faintly distributed within the epithelial layer and weakly induced upon RSV infection. By contrast, CCL20 IF was strongly induced in the smaller airways, both upon RSV infection. These (&lt;1 mm diameter) airways were lined with single layer of cuboidal epithelium and lacked cartilage representing bronchiolar and terminal bronchiolar structures (adjacent to alveoli). 
     To examine whether enhanced mucin production was seen in this model, tissue sections were stained with PAS to assess mucin production. We observed enhanced PAS staining in these smaller, distal airways. Together, these studies confirm that lower airway epithelial cells in the distal airways produce enhanced CCL20 expression with increased mucin production in this mouse model of RSV infection. 
     Discussion 
     In this study, we apply unbiased proteomics to identify 577 high-confidence proteins whose RSV-induced expression patterns differ between primary human epithelial cells derived from the conductive airway (trachea) and those of the small airways (bronchioles). A surprising finding was that about third of the proteins identified in the secretome are exosomal. Although a number of RSV-inducible proteins are common, RSV induces a group of proteins unique to the phSAECs that are immunologically significant—TSLP, CCL20, CCL3-L1 and IL-6. Differential expression of these proteins was independently validated by specific SID-SRM-MS assays. We demonstrate that CCL20 is the major mucin-promoting cytokine in hSAECs secretome, and validate its preferential expression in lower airways in a BALB/c mouse model of RSV infection. These data advance our understanding of the epithelial innate response and provide insight into how RSV LRTI is associated with enhanced mucin production and lower airway obstruction. Our study surprisingly shows the novel observation that TSLP and CCL20 are preferentially secreted by RSV-infected lower airway epithelial cells, perhaps providing information on how LRTI is associated with Th2 lymphocyte skewing, DC recruitment and Th17 activation. 
     Example 9 
     Exosome Preparation and Characterization 
     Exosomes are small 90-100 nm extracellular vesicles derived from endosomal multivesicular bodies (exosomes) that function in extracellular signal transduction. Enclosed within protective phospholipid bilayers, exosomes proteins, vasoactive leukotrienes, and small RNAs (sncRNA and miRNAs), whose dynamic composition is determined by the microenvironment of the secreting cell. Currently we understand that exosomes participate in signal transduction in distant target cells, affect cellular behavior. With greater understanding of how exosomal content is affected by changes in the microenvironment of the cellular origin, profiling and quantification of exosome content may be used as “liquid biopsies” to detect occult cellular stress, inflammation, tissue injury, wound healing, tissue remodeling and cancer. Although much study has focused on exosomes in the circulation, virtually all cell types produce exosomes and consequently they are found in virtually all biological fluids, including the airway. 
     To characterize; 1) the proteomic, RNA and metabolic content of exosome; 2) exosomal activities and 3) exosomal function, sample collection and storage conditions need to be identified that have minimal impact on exosome integrity. We characterized the effects of storage conditions on airway exosome composition, integrity and morphology 
     By comparing surface and morphological properties as well as protein content of enriched exosomes from the airway following storage at 4° C. and at −80° C. As part of these efforts enriched exosomes were isolated by differential ultracentrifugation from mouse bronchoalveolar lavage after poly(I:C)-induced airway inflammation, washed in PBS and stored at 4° C. and −80° C. Exosomal structure was assessed by dynamic light scattering (DLS), transmission electron microscopy (TEM) and charge density (zeta potential, ζ). Protein content, as well as leaking/dissociating peri-exosomal proteins were identified by label-free LC-MS/MS. 
     Results 
     Storage Conditions Affect Exosome Size: 
     In our studies of BALF exosomes, we observed that freshly prepared exosomes had distinct dynamic light scattering (DLS) patterns compared to those frozen at −80° C. Intrigued that storage conditions may introduce a systematic effect, we undertook a more systematic investigation into effects of freezing on BALF exosome structure and content. For this a pool of enriched exosomes was freshly prepared from the BALF, washed in PBS, measured, aliquoted and stored at 4° C. and at −80° C. 
     The Z-average DLS % intensity size distribution metric was compared for the different storage conditions. Freshly prepared BALF exosomes produced an asymmetric size distribution of vesicles from 50-170 nm, with an average size of 94.5±1.7 nm. By contrast, exosomes stored at 4° C. underwent a size shift of its average size to 104±1.15 nm in three independent isolations (p&lt;0.05, t-test). A much more dramatic change was observed for BALF exosomes stored at −80° C., where the average increased to 125±1.15 nm (p&lt;0.001, t-test). In addition to this increase in exosome size, a Poisson like distribution and high PDI shift in the DLS profile was noted, indicating polydispersity in the samples. Multiple overlapping Gaussian size distributions results in a long tail mixture model, suggesting freezing produced a population of larger nanovesicle aggregates up to 400 nm in diameter. 
     To further understand the influence of storage effects on exosome ultrastructure, we subjected the exosomes to ultrastructural studies using transmission electron microscopy (TEM). Both the freshly prepared BALF exosomes and those stored at 4° C. appeared in TEM as isolated, membrane-encapsulated nanovesicles, with the characteristic artificial central depression (“cupping”) ascribed to cellulose embedding. By contrast, the fraction of the BALF exosomes stored at −80° C. were larger, aggregated and showed appearance of multi-lamellar membrane layers, consistent with the results of the study using dynamic light scattering to assess changes induced in exosome by freezing and thawing of samples. 
     Storage Effects on Zeta Potential (ζ): 
     We next examined the effect of storage conditions on the charge density distribution around the exosome, a parameter known as the zeta potential. Exosomes from BAL that were freshly prepared and stored at 18° C. demonstrated ζ between −34.8 and −32.4 mV. These ζ are within the potential range expected for airway exosomes due to the high distribution of negatively charged membrane phospholipids (36). It is remarkable that after thawing from −80° C., the ζ was further diminished to −16.5 mV to −9.88 mV, indicating that freezing is extremely disruptive to the structure and physical properties of the BALF exosomes. Importantly, at such ζ, the exosomes possess virtually no barrier against fusion processes, providing a physicochemical explanation for the exosomal fusion in TEM and increased size by DLS. 
     Effect of Storage Conditions on Protein Content: 
     To determine whether the different storage conditions affected the exosomal protein content, we conducted unbiased label-free quantitation of the exosomes after 4° C. and −80° C. storage. Three individual replicate analyses from two independent experiments were conducted to measure changes in protein content. Unbiased proteome profiling was conducted by LC-MS/MS analysis after lipid depletion using an optimized chloroform/methanol precipitation method. A total of 848 proteins were identified at an FDR of 1% or less. This protein set was enriched in proteins important in translation/ribosomal RNA processing, vesicular transport and cytoskeletal structure (Table III), compatible with the functions and subcellular origin of exosomes. Moreover, 80 of the top 100 exosomal proteins in Exocarta were identified, establishing that this preparation was enriched in exosomes. Functional analysis showed that these proteins were significantly enriched in 39 biological pathways, including tRNA aminoacylation, glycolysis, translation, macrophage activation, proteolysis and others (Table IV). 
     To compare the effect of storage in exosome content, we examined a measure of differential expression (−log 10 transformed p value of two sample t-test) vs the fold change of proteins abundance in exosome (4° C. relative to −80° C.) using a volcano plot. From this analysis, 755 (89%) of proteins shown no difference in abundance in exosome as a result of the storage temperature. However, 61 proteins were more abundant in the exosomes stored at −80° C. relative to exosome stored at 4° C., by contrast, and 31 proteins were more abundant in the exosomes stored at 4° C. relative to those stored at −80° C., indicating that a small population of exosome proteins was more sensitive to the storage temperature. Consistency in the changes in protein abundance by replicate were analyzed by hierarchical clustering of the log 2-normalized abundance. 
     Protein Leakage and Dissociation into the Supernatant Upon Storage 
     To further understand the effects of storage, we used LC-MS to identify and quantify the proteins in supernatant after 4° C. and −80° C. storage. A total of 698 proteins were identified with high confidence, and functionally analyzed by GO classification. Interestingly, these proteins affect biological pathways that are functionally distinct from those identified in the exosomal preparation. For example, the supernatant proteins are enriched in carbohydrate metabolism (gluconeogenesis/glycolysis), TCA cycle and fatty acid biosynthesis pathways (Table V). We noted that expression of 554 proteins are unchanged, appearing in the supernatant independently of storage conditions. Interestingly, a smaller group of the peri-exosomal proteins appear in the supernatants dependent on the storage conditions. 67 proteins are enriched in the supernatant from the exosomes stored at −80° C., and a second set of 78 unique proteins is enriched in the exosomes stored at 4° C. (p&lt;0.05). 
     We next analyzed the supernatant fractions for the presence of the 62 proteins depleted from the exosome preparations stored at 4° C. We found that 22 proteins depleted during 4° C. storage did not appear in the supernatant. We interpret this data to mean that these proteins were metabolized or degraded at 4° C. Conversely, 29 of the 31 proteins depleted from the exosome preparations stored at −80° C. appeared in the soluble supernatant. We interpret this finding to indicate that 93% proteins lost at −80° C. leaked into the supernatant due to membrane fusion and/or membrane disruption. 
     BALF exosomes undergo dynamic changes in protein (cytokines), arachidonic acid (leukotrienes) and miRNA content that could potentially regulate innate immunity, hyper-responsiveness and cellular inflammation in the airway. Although our study was not designed to examine the effect of poly(I:C) inflammation on exosomal content, our data significantly extends the number of proteins contained within BALF exosomes. Here we identify 848 high confidence proteins that are enriched in 80 of the top 100 proteins in the ExoCarta database that have previously been identified as exosomal markers. Pathway analysis indicates that the poly(I:C) induced exosomes are enriched in a number of biological processes. These enriched biological processes include tRNA aminoacylation and protein translation (Table IV), perhaps participating in the processing or activity of the miRNA content. 
     In summary, our studies demonstrate that freezing and subsequent thawing resulted in an increase in exosomal size, promoting aggregation and multilamellar vesicle formation. Storage at −80° C. resulted in increasing the size of exosome by more than 20% while producing ζ compatible with vesicular fusion. A total of 848 proteins were identified in the exosomes, significantly enriched in ribosomal/translation, vesicular and cytoskeletal functions mapped into 39 biological pathways. 62 inflammation and integrin signaling proteins were depleted in exosomes stored at 4° C. 31 coagulation and cellular metabolic proteins were depleted in exosomes stored at −80° C. storage. After 4° C. storage, 224 proteins appeared in the supernatant relative to that in the wash representing exosomal leakage and peri-exosomal protein dissociation. After −80° C. storage and thawing cycle, 194 proteins appeared in the supernatant vs that of the original wash, suggesting distinct protein groups leak from exosomes based on storage conditions. 
     CONCLUSIONS 
     Storage destabilizes surface characteristics and protein content of airway exosomes. For preservation of exosomal content and functional analysis, airway exosomes should be isolated and immediately analyzed. 
     
       
         
           
               
             
               
                 TABLE III 
               
             
            
               
                   
               
               
                 Subcellular Compartment Enrichment of exosomal proteins. 848 
               
               
                 high confidence proteins were analyzed for subcellular enrichment 
               
               
                 by GO-Slim (Panther database). Shown is fold enrichment of 
               
               
                 the pathway and p value (bonferroni correction). 
               
            
           
           
               
               
               
            
               
                 PANTHER GO-Slim Cellular Component 
                 Enrichment 
                 P value 
               
               
                   
               
            
           
           
               
               
               
            
               
                 ribosome (GO:0005840) 
                 12.64 
                 1.09E−36 
               
               
                 cytosol (GO:0005829) 
                 7.4 
                 9.33E−40 
               
               
                 vesicle coat (GO:0030120) 
                 6.53 
                 2.49E−03 
               
               
                 ribonucleoprotein complex (GO:0030529) 
                 6.16 
                 7.39E−29 
               
               
                 actin cytoskeleton (GO:0015629) 
                 4.43 
                 8.50E−10 
               
               
                 macromolecular complex (GO:0032991) 
                 2.7 
                 2.40E−21 
               
               
                 cytoskeleton (GO:0005856) 
                 2.47 
                 2.05E−06 
               
               
                 cytoplasm (GO:0005737) 
                 2.43 
                 1.58E−23 
               
               
                 extracellular space (GO:0005615) 
                 2.26 
                 4.94E−05 
               
               
                 organelle (GO:0043226) 
                 2.07 
                 8.58E−19 
               
               
                 intracellular (GO:0005622) 
                 1.92 
                 1.34E−23 
               
               
                 cell part (GO:0044464) 
                 1.89 
                 2.08E−22 
               
               
                 extracellular region (GO:0005576) 
                 1.83 
                 1.87E−03 
               
               
                 membrane (GO:0016020) 
                 0.36 
                 9.08E−11 
               
               
                 plasma membrane (GO:0005886) 
                 0.32 
                 2.36E−07 
               
               
                 integral to membrane (GO:0016021) 
                 &lt;0.2 
                 4.91E−15 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE IV 
               
             
            
               
                   
               
               
                 Pathway enrichment of exosomal proteins. 848 high confidence proteins were 
               
               
                 analyzed for biological processes by GO-Slim (Panther database). Shown 
               
               
                 is fold enrichment of the pathway and p value (bonferroni correction). 
               
            
           
           
               
               
               
            
               
                 PANTHER GO-Slim Biological Process 
                 Enrichment 
                 P-Value 
               
               
                   
               
            
           
           
               
               
               
            
               
                 tRNA aminoacylation for protein translation (GO:0006418) 
                 8.02 
                 1.49E−05 
               
               
                 glycolysis (GO:0006096) 
                 6.5 
                 1.03E−02 
               
               
                 translation (GO:0006412) 
                 6.19 
                 1.07E−28 
               
               
                 protein complex assembly (GO:0006461) 
                 5.14 
                 1.25E−09 
               
               
                 protein complex biogenesis (GO:0070271) 
                 5.11 
                 1.43E−09 
               
               
                 protein folding (GO:0006457) 
                 4.8 
                 9.06E−06 
               
               
                 purine nucleobase metabolic process (GO:0006144) 
                 4.69 
                 3.61E−03 
               
               
                 chromatin organization (GO:0006325) 
                 4.21 
                 4.20E−11 
               
               
                 cellular component biogenesis (GO:0044085) 
                 3.8 
                 3.07E−16 
               
               
                 macrophage activation (GO:0042116) 
                 3.49 
                 3.16E−02 
               
               
                 fatty acid metabolic process (GO:0006631) 
                 2.99 
                 1.98E−03 
               
               
                 cellular amino acid metabolic process (GO:0006520) 
                 2.97 
                 5.57E−04 
               
               
                 cellular component organization or biogenesis (GO:0071840) 
                 2.76 
                 9.64E−30 
               
               
                 proteolysis (GO:0006508) 
                 2.58 
                 1.29E−07 
               
               
                 cellular component organization (GO:0016043) 
                 2.5 
                 3.19E−20 
               
               
                 organelle organization (GO:0006996) 
                 2.47 
                 2.56E−08 
               
               
                 catabolic process (GO:0009056) 
                 2.46 
                 2.20E−08 
               
               
                 protein metabolic process (GO:0019538) 
                 2.23 
                 7.53E−20 
               
               
                 lipid metabolic process (GO:0006629) 
                 2.02 
                 7.65E−03 
               
               
                 cellular component morphogenesis (GO:0032989) 
                 1.99 
                 3.17E−02 
               
               
                 biosynthetic process (GO:0009058) 
                 1.78 
                 2.68E−05 
               
               
                 protein transport (GO:0015031) 
                 1.77 
                 5.21E−03 
               
               
                 intracellular protein transport (GO:0006886) 
                 1.75 
                 1.06E−02 
               
               
                 vesicle-mediated transport (GO:0016192) 
                 1.73 
                 2.48E−02 
               
               
                 primary metabolic process (GO:0044238) 
                 1.68 
                 6.64E−24 
               
               
                 metabolic process (GO:0008152) 
                 1.57 
                 2.82E−21 
               
               
                 transport (GO:0006810) 
                 1.54 
                 2.67E−03 
               
               
                 localization (GO:0051179) 
                 1.53 
                 1.14E−03 
               
               
                 cellular process (GO:0009987) 
                 1.32 
                 1.41E−09 
               
               
                 Unclassified (UNCLASSIFIED) 
                 0.57 
                 0.00E+00 
               
               
                 cell surface receptor signaling pathway (GO:0007166) 
                 0.52 
                 1.08E−02 
               
               
                 system process (GO:0003008) 
                 0.51 
                 1.07E−03 
               
               
                 single-multicellular organism process (GO:0044707) 
                 0.49 
                 8.83E−06 
               
               
                 multicellular organismal process (GO:0032501) 
                 0.47 
                 1.18E−06 
               
               
                 developmental process (GO:0032502) 
                 0.46 
                 5.25E−05 
               
               
                 transcription, DNA-dependent (GO:0006351) 
                 0.39 
                 7.53E−05 
               
               
                 transcription from RNA polymerase II promoter (GO:0006366) 
                 0.35 
                 2.40E−04 
               
               
                 neurological system process (GO:0050877) 
                 0.32 
                 1.08E−07 
               
               
                 regulation of transcription from RNA polymerase II promoter 
                 0.25 
                 9.67E−05 
               
               
                 (GO:0006357) 
               
               
                 sensory perception (GO:0007600) 
                 &lt;0.2 
                 1.79E−09 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE V 
               
             
            
               
                   
               
               
                 GO analysis of peri-exosomal proteins. 699 high confidence peri-exosomal proteins 
               
               
                 were analyzed for biological processes by GO-Slim (Panther database). Shown 
               
               
                 is fold enrichment of the pathway and p value (bonferroni correction). 
               
            
           
           
               
               
               
            
               
                 PANTHER GO-Slim Biological Process 
                 Enrichment 
                 Pvalue 
               
               
                   
               
            
           
           
               
               
               
            
               
                 gluconeogenesis (GO:0006094) 
                 10.99 
                 5.44E−03 
               
               
                 tricarboxylic acid cycle (GO:0006099) 
                 10.45 
                 1.57E−03 
               
               
                 glycolysis (GO:0006096) 
                 9.8 
                 1.28E−04 
               
               
                 fatty acid biosynthetic process (GO:0006633) 
                 6.3 
                 1.53E−03 
               
               
                 purine nucleobase metabolic process (GO:0006144) 
                 6.28 
                 1.90E−04 
               
               
                 protein complex assembly (GO:0006461) 
                 5.16 
                 4.86E−07 
               
               
                 protein complex biogenesis (GO:0070271) 
                 5.13 
                 5.40E−07 
               
               
                 blood coagulation (GO:0007596) 
                 4.62 
                 9.15E−03 
               
               
                 monosaccharide metabolic process (GO:0005996) 
                 4.2 
                 1.01E−02 
               
               
                 chromatin organization (GO:0006325) 
                 4.04 
                 2.32E−07 
               
               
                 macrophage activation (GO:0042116) 
                 3.96 
                 3.51E−02 
               
               
                 fatty acid metabolic process (GO:0006631) 
                 3.83 
                 7.00E−05 
               
               
                 translation (GO:0006412) 
                 3.64 
                 1.18E−06 
               
               
                 proteolysis (GO:0006508) 
                 3.59 
                 1.14E−13 
               
               
                 cellular component biogenesis (GO:0044085) 
                 3.45 
                 2.17E−09 
               
               
                 cellular amino acid metabolic process (GO:0006520) 
                 3.34 
                 5.79E−04 
               
               
                 generation of precursor metabolites and energy (GO:0006091) 
                 3.22 
                 2.96E−03 
               
               
                 catabolic process (GO:0009056) 
                 2.98 
                 7.38E−11 
               
               
                 lipid metabolic process (GO:0006629) 
                 2.78 
                 1.97E−06 
               
               
                 cellular component organization or biogenesis (GO:0071840) 
                 2.58 
                 4.22E−18 
               
               
                 cellular component organization (GO:0016043) 
                 2.45 
                 4.05E−14 
               
               
                 cellular component morphogenesis (GO:0032989) 
                 2.21 
                 2.02E−02 
               
               
                 organelle organization (GO:0006996) 
                 2.15 
                 1.30E−03 
               
               
                 protein metabolic process (GO:0019538) 
                 2.12 
                 3.65E−12 
               
               
                 immune system process (GO:0002376) 
                 1.79 
                 3.12E−03 
               
               
                 primary metabolic process ((30:0044238) 
                 1.69 
                 2.39E−18 
               
               
                 transport (GO:0006810) 
                 1.61 
                 3.94E−03 
               
               
                 metabolic process (GO:0008152) 
                 1.58 
                 2.75E−16 
               
               
                 localization (GO:0051179) 
                 1.55 
                 9.11E−03 
               
               
                 cellular process (GO:0009987) 
                 1.24 
                 1.05E−03 
               
               
                 multicellular organismal process (GO:0032501) 
                 0.58 
                 2.03E−02 
               
               
                 Unclassified (UNCLASSIFIED) 
                 0.57 
                 0.00E+00 
               
               
                 RNA metabolic process (GO:0016070) 
                 0.53 
                 1.81E−02 
               
               
                 developmental process (GO:0032502) 
                 0.5 
                 7.71E−03 
               
               
                 cell surface receptor signaling pathway (GO:0007166) 
                 0.42 
                 4.02E−03 
               
               
                 neurological system process (GO:0050877) 
                 0.34 
                 4.45E−05 
               
               
                 transcription from RNA polymerase II promoter (GO:0006366) 
                 0.27 
                 2.92E−04 
               
               
                 regulation of transcription from RNA polymerase II promoter 
                 0.25 
                 3.13E−03 
               
               
                 (GO:0006357) 
               
               
                 sensory perception (GO:0007600) 
                 0.25 
                 7.18E−05 
               
               
                 G-protein coupled receptor signaling pathway (GO:0007186) 
                 0.25 
                 1.22E−02