Exosomal glypican-1 is elevated in pancreatic cancer precursors and can signal genetic predisposition in the absence of endoscopic ultrasound abnormalities

Figure 1 Schematic representation of the workflow for the analysis of circulating exosomes from control group, mucinous cystic lesions, hereditary risk and new-late onset diabetes mellitus patients for the expression of glypican-1. Scheme illustrating the workflow of our study of the expression of glypican-1 (GPC1) on exosomes retrieved from patients’ blood samples, from blood collection to the analysis by flow cytometry of GPC1⁺ circulating exosomes (crExos). A representative histogram of the percentage of beads bound to GPC1-positive crExos (GPC1⁺ crExos) that were isolated from the serum of a control group, composed by individuals submitted to endoscopic ultrasound for other reasons than pancreatic pathology, as well as the following pancreatic ductal adenocarcinoma risk groups: Mucinous cystic lesions, hereditary risk, and new-late onset diabetes mellitus. Red dashed lines in each histogram depict the start of the fluorescein isothiocyanate (FITC)-positive gate (anti-immunoglobulin G) Alexa Fluor 488), which was determined for each patient separately by considering FITC+ approximately 1% on control–secondary–but maintained between control and GPC1 samples. GPC1: Glypican-1; FITC: Fluorescein isothiocyanate; crExos: Circulating exosomes.