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Activation of the pentose phosphate pathway in macrophages is crucial for granuloma formation in sarcoidosis
Satoshi Nakamizo, … , Gyohei Egawa, Kenji Kabashima
Satoshi Nakamizo, … , Gyohei Egawa, Kenji Kabashima
Published December 1, 2023
Citation Information: J Clin Invest. 2023;133(23):e171088. https://doi.org/10.1172/JCI171088.
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Research Article Dermatology Immunology

Activation of the pentose phosphate pathway in macrophages is crucial for granuloma formation in sarcoidosis

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Abstract

Sarcoidosis is a disease of unknown etiology in which granulomas form throughout the body and is typically treated with glucocorticoids, but there are no approved steroid-sparing alternatives. Here, we investigated the mechanism of granuloma formation using single-cell RNA-Seq in sarcoidosis patients. We observed that the percentages of triggering receptor expressed on myeloid cells 2–positive (TREM2-positive) macrophages expressing angiotensin-converting enzyme (ACE) and lysozyme, diagnostic makers of sarcoidosis, were increased in cutaneous sarcoidosis granulomas. Macrophages in the sarcoidosis lesion were hypermetabolic, especially in the pentose phosphate pathway (PPP). Expression of the PPP enzymes, such as fructose-1,6-bisphosphatase 1 (FBP1), was elevated in both systemic granuloma lesions and serum of sarcoidosis patients. Granuloma formation was attenuated by the PPP inhibitors in in vitro giant cell and in vivo murine granuloma models. These results suggest that the PPP may be a promising target for developing therapeutics for sarcoidosis.

Authors

Satoshi Nakamizo, Yuki Sugiura, Yoshihiro Ishida, Yoko Ueki, Satoru Yonekura, Hideaki Tanizaki, Hiroshi Date, Akihiko Yoshizawa, Teruasa Murata, Kenji Minatoya, Mikako Katagiri, Seitaro Nomura, Issei Komuro, Seishi Ogawa, Saeko Nakajima, Naotomo Kambe, Gyohei Egawa, Kenji Kabashima

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Figure 1

Identification of APC subsets.

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Identification of APC subsets.
(A) UMAP plot showing APCs from 3 sarcoid...
(A) UMAP plot showing APCs from 3 sarcoidosis patients and 5 healthy subjects colored by subset. LC, Langerhans cells; cDC1, conventional type 1 dendritic cells; cDC2, conventional type 2 dendritic cells; mregDC, mature dendritic cells enriched in immunoregulatory molecules; resident, skin resident macrophages; TREM2, TREM2 macrophages. (B) Heatmap showing marker genes for each subset. Representative genes are labeled. (C) UMAP plot split by healthy and sarcoidosis samples. (D) An abundance of each APC subset. Šídák’s multiple-comparisons test was conducted between the healthy and sarcoidosis samples for each subset. *P < 0.05. (E) Volcano plot comparing TREM2 macrophages against other APCs. MAC, macrophages. (F) Violin plots showing expression of ACE, LYZ, CD163, TREM2, FBP1, FN1, APOC1, and APOE in APC subsets in all skin samples. (G) Representative immunofluorescence staining in healthy (n = 3) and sarcoidosis (n = 3) skin biopsy samples for expression of CD68 in gray, FBP1 in red, CD163 in green, and DAPI in blue. Scale bars: 100 μm.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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