Nature Immunology

Fibroblasts play a dual role in shaping tissue homeostasis and immune responses during inflammatory perturbations. Manipulating fibroblast behavior has therefore emerged as a promising strategy for autoimmune diseases. Here, through integrated multimodal single-cell transcriptomic and proteomic profiling of synovial tissue combined with prospective clinical data from 54 patients with rheumatoid arthritis, we identify C-X-C motif chemokine 12 (CXCL12)hi Apolipoprotein C1 (APOC1)+ fibroblasts as a pathogenic cell population driving refractory synovitis. CXCL12hi APOC1+ fibroblasts construct local niche in spatial coordinates with plasmablasts via the CXCL12-CXCR4 axis. APOC1 orchestrates senescent inflammatory cancer-associated fibroblast(iCAF)-like properties of this cluster through activation of the STAT3-C/EBP pathway. Therapeutic elimination of senescent cells, either alone or in combination with TNF inhibition, significantly ameliorates experimental arthritis. Together, these findings uncover a mechanistic basis for treatment resistance in rheumatoid arthritis and highlight senescent iCAF-like fibroblasts as a promising therapeutic target.

Respiratory viral infections in early childhood are major drivers of acute morbidity and long-term airway disease, yet how distinct viruses remodel the pediatric nasal mucosa at cellular resolution remains unresolved. Here, we generated a single-cell RNA sequencing atlas of 335,174 nasal epithelial and immune cells from 132 children under five years of age with SARS-CoV-2, rhinovirus, or respiratory syncytial virus (RSV) infection, alongside uninfected controls. Mapping viral transcripts to individual cells revealed virus-specific infected epithelial states: an NF-kB-responsive ciliated subset in SARS-CoV-2 and a previously undescribed KRT17+ squamous-like subset in RSV. We delineated divergent mucosal response programs, including a robust interferon (IFN) response in SARS-CoV-2, an IL-13-responsive secretory program in rhinovirus, and heightened inflammatory and cytotoxic immune activation in RSV. In RSV, specific immune subsets and elevated IFN-response signatures were associated with disease severity, whereas rhinovirus-induced wheeze was marked by expansion of a CST1+ goblet cell subset. Integration of asthma genome-wide association data with our atlas revealed a KRT13+ hillock-like squamous epithelial subset enriched for expression of childhood-onset asthma risk loci. Finally, we demonstrate that this resource enables high-resolution annotation of independent pediatric cohorts in Kolkata, India and rural Bangladesh. Together, this atlas establishes a comprehensive view of antiviral immunity in the pediatric nasal mucosa and defines virus-specific mucosal immune programs relevant to disease severity and asthma risk in early life.

Booster vaccination can restore antibody titres and protection, but whether it improves long-term durability by expanding plasma cell (PC) numbers or also by shifting PC fate toward intrinsically longer-lived states remains unclear. Here we established longitudinal in vivo ground truth for PC persistence by combining PC-specific genetic timestamping, clonal tracking, and multi-timepoint single-cell profiling across spleen and bone marrow. We resolved PC longevity as a layered, non-binary architecture comprising short-, intermediate-, and long-lived programs, and showed that program identity is specified early in secondary lymphoid tissues and largely maintained as PCs populate bone marrow niches. Primary vaccine responses initiated from naive B-cells generated a prominent intermediate-lived wave, whereas memory B-cell recall during boosting redistributed output toward long-lived programs rather than recreating the intermediate-lived compartment characteristic of priming. Conserved longevity signatures projected onto early circulating PCs provide a cross-species framework to infer durability programs, supporting benchmarking of vaccine regimens by predicted persistence rather than peak titres. HighlightsO_LIGenetic timestamping resolves short-, intermediate-, and long-lived PC programs C_LIO_LILongevity programs are imprinted early and maintained from lymphoid organs to bone marrow C_LIO_LICross-species signatures stratify human blood and bone marrow PCs by persistence C_LIO_LIBoosting via MBC recall enriches long-lived PC and contracts the intermediate-lived tier C_LI

Systemic vaccination induces serum antibodies and circulating memory B cells but provides limited protection in the upper respiratory tract, where many respiratory pathogens initiate infection. How systemic memory B cells contribute to mucosal immunity remains unclear. Using multiparametric flow cytometry, single-cell RNA and V(D)J sequencing, and functional analyses of paired blood and nasal/oropharyngeal samples, we characterized human B cells across systemic and mucosal compartments. Swab-derived B cells transcriptionally overlap with circulating activated memory B cells while exhibiting distinct features of activation, tissue retention, and spontaneous IgA/IgG secretion. Approximately 6% of mucosal B-cell clones were shared with blood, indicating systemic-mucosal connectivity. Both infection and vaccination expanded two circulating antigen-specific activated memory B cells subsets, whereas antigen-specific B cells accumulated in the upper respiratory tract only following local inflammation. The finding that B-cell recruitment is reactive rather than preemptive may explain the limited efficacy of parenteral vaccines and provides a rationale for developing integrated systemic-mucosal vaccination strategies.

How plasma cells (PCs) shape anti-tumor immunity is unclear. We hypothesized that conflicting prognostic associations reflect differences in immune context and PC ontogeny. We identify extrafollicular (EF)-PCs as an antibody-independent checkpoint that aborts priming by disabling the cDC1[->]CD8+ T-cell axis in tumor-draining lymph nodes (td-LNs). EF-PCs blunt cDC1 activation and CCR7-guided repositioning into T-cell zones, precluding formation of TCF1 stem-like CD8 T-cells. Depleting EF-PCs in vivo restores cDC1 trafficking, expands the stem-like reservoir, increases intratumoral CD8 infiltration, and restrains tumor growth; benefit is lost with CD8 T-cell ablation. Neither serum transfer nor Fc{gamma} receptor blockade reverses tumor control, supporting a non-canonical, antibody-independent mechanism. Across independent triple-negative breast cancer cohorts, we find EF-PC hyperplasia in td-LNs and tumors; and within immune-cold cases, EF-PC burden stratifies poor prognosis and metastatic risk. A cross-species EF-PC signature maps to a conserved PC-state across cancer types that is linked to poor outcome and immune-checkpoint blockade resistance. EF-PCs thus relocate the dominant failure point to td-LNs and offer a tractable upstream target to convert immune-cold tumors into immune-responsive disease.

AO_SCPLOWBSTRACTC_SCPLOWThe biology that governs progression and therapeutic response in autoimmune disease is organized in affected tissue, but direct molecular readout of that biology requires invasive biopsy and is rarely repeated during clinical trials or routine care. Using paired blood-skin single-cell RNA-sequencing from a systemic sclerosis (SSc) cohort of 74 individuals (57 patients and 17 matched controls, 192,809 cells across 53 annotated cell states), we show that peripheral blood carries a recoverable projection of tissue-resident molecular state. Across 63 pathways scored in both compartments, 43 same-pathway blood-skin associations reach FDR < 0.05; at cell-type resolution, 212 cross-compartment associations survive residualization for disease status and sex. Per-patient classifiers recover tissue-defined molecular states out of fold with AUCs between 0.62 and 0.79, with the strongest recoveries on fibroblast subtype programs that have no direct circulating analog: fibroblast COMP at 0.79, COCH at 0.75, MYOC2 at 0.74, POSTN at 0.74. Tissue programs route through different blood compartments at different representational levels: fibroblast programs resolve through T-cell, Treg, monocyte and B-cell axes at compositional and distributional levels, while interferon resolves through expression state across multiple cell types. Within SSc alone, a cross-validated partial least squares model learns a shared blood-skin latent axis at r = 0.486 (permutation p = 0.006); the induced patient ranking recovers tissue-interferon-high patients at 86% precision at the top-20% screening threshold against a 50% base rate. A paired multiview autoencoder, trained on module-level dependency structure under contrastive alignment, paired reconstruction, neighborhood preservation and tissue-target supervision, learns a shared latent geometry in which blood-only projections land in the same tissue-state region as their matched tissue samples and supports recovery of held-out tissue targets above simpler baselines and above two permutation null families. These results map the empirical geometry of cross-compartment inference in autoimmune disease and position peripheral blood as a substrate for tissue-state inference at trial and clinical scale.

During ageing, hematopoietic stem cells (HSCs) have reduced regenerative potential, skewed differentiation toward the myeloid lineage, and heightened susceptibility to clonal expansion and malignancy. While epigenetic alterations are well documented, the impact of aging on higher-order 3D chromatin architecture remains poorly understood. Here, we examined the 3D genome organisation of aged murine HSCs using in-situ Hi-C then integrated this with gene expression and chromatin accessibility data to build HiC-informed gene regulatory networks (GRNs). Aged HSCs display erosion of topologically associating domain (TAD) boundaries, A/B compartment switching, and reorganised enhancer-promoter loops associated with lineage-inappropriate gene expression. Our GRN analysis identifies a hierarchy of transcription factors, including a c-Maf-Lyl1-Mnt axis that orchestrates the transition from a youthful to aged state and a Gfi1-Sox4 axis in young HSCs that regulates Bach1. This study provides a structural blueprint for aging HSCs and defines specific regulatory targets for potential reprogramming interventions to restore hematopoietic youthfulness.

Vaccination programs worldwide have effectively reduced the burden of childhood diseases, yet immune responses remain highly heterogeneous among individuals. While host characteristics such as age and sex are established determinants of vaccine immunogenicity, the timing of vaccination, specifically the calendar season of vaccination, remains largely underexplored. Although circadian rhythms are known to regulate daily immune function, evidence for long-term circannual patterns has been limited by the difficulty of collecting year-round vaccination data across diverse populations. Here, we show that the season of vaccination systematically shapes the immune response across a broad range of pediatric vaccines. By leveraging data from 96 randomized control trials worldwide, including over 48,000 children vaccinated against 14 pathogens, we demonstrate that immunogenicity after vaccination follows a pronounced latitudinal gradient, typically peaking during colder months in temperate regions and exhibiting distinct variability in the tropics. These findings suggest that the circadian human immune response might extend to a circannual scale, potentially synchronized by environmental cues. Incorporating the season of vaccination into the design of clinical trials and public health campaigns may optimize vaccine performance and enhance seroprotection.

Food provides nutrients that are selectively absorbed by the intestine, but, at the same time, may contain elements that challenge the intestinal barrier and induce post-prandial inflammation (PPI). How PPI is controlled in order to avoid pathological perturbation of homeostasis remains unclear. Here, we report that during fasting, enterocytes increase their absorptive potential and oxidative metabolism, a program that is largely reversed upon food intake of lipids that perturb the intestinal barrier and induce PPI. Such perturbation is countered by ILC3s, in the absence of which PPI increases, program reversal does not occur, and enterocytes engage into excessive oxidative metabolism. This enterocyte state leads to critical hypoglycemia as a consequence of decreased glucose absorption and increased insulinemia, recapitulating the pathological situation found in patients suffering from intestinal damage and sepsis. We hereby uncover a critical function for ILC3s in maintaining enterocyte homeostasis upon challenging food intake.

Rheumatoid arthritis affects millions of people worldwide, yet a substantial fraction of patients fail to achieve lasting benefit from current therapies. AI-based virtual cell models offer a promising route to simulate the effects of thousands of potential drug targets computationally, but whether their predictions genuinely reflect what happens in the disease-relevant cells of patients undergoing treatment has been unclear. Here, we introduce ImmunoSTATE, a clinically anchored framework that benchmarks empirical and virtual perturbations directly against patient-derived treatment trajectories in pathogenic CXCL13+ synovial T cells from nine patients with rheumatoid arthritis sampled before and after treatment. Empirical genome-wide CRISPR interference screening prioritizes T cell receptor (TCR)-proximal signaling over the measurable components of the JAK-STAT pathway for transcriptomic reversal of the disease signature, a result that remained robust across leave-one-patient-out reanalyses. Comparison of virtual perturbation signals across healthy donor CD4+ T cells and rheumatoid-arthritis patient cells reveals broad preservation of target priorities, together with selected disease-context-enriched shifts, including stronger prioritization of SOX4 in patient cells. ImmunoSTATE provides a clinically anchored framework for evaluating virtual cell models in disease-relevant immune contexts and demonstrates that distinguishing training-set status and cellular context are essential steps in the reliable interpretation of virtual perturbation outputs.

Survival during infection depends on both pathogen clearance and the ability to tolerate infection-induced physiological changes. Metabolic adaptations are a central component of this tolerance, but the mechanisms underlying these responses remain incompletely defined. Here, we identify white adipose tissue (WAT) lipolysis as a central regulator of metabolic tolerance to infection. In patients with sepsis, higher circulating non-esterified fatty acid (NEFA) levels were associated with reduced mortality. In mouse models of polymicrobial sepsis, infection induced robust adipose lipolysis and increased circulating NEFAs. Genetic ablation of adipose triglyceride lipase (ATGL) in adipose tissue impaired lipolysis, leading to hypothermia, bradycardia, and increased mortality without altering immune cell populations or pathogen burden, consistent with a defect in tolerance rather than resistance. Mechanistically, lipolysis-derived NEFAs, but not glycerol, were required for protection, as restoring circulating NEFAs rescued autonomic stability and survival in adipose tissue ATGL-deficient mice. Infection-induced lipolysis was redundantly regulated and did not depend on any single upstream signaling pathway. Both pharmacologic activation of lipolysis using a {beta}3-adrenergic agonist and exogenous fatty acid supplementation increased circulating NEFAs, improved survival, and promoted tolerance in mice. Consistent with these findings, analysis of real-world electronic health record data demonstrated that septic patients receiving FDA-approved {beta}3-adrenergic agonists had reduced mortality or hospice discharge in a propensity-matched cohort. Together, these results identify WAT lipolysis and circulating fatty acids as key mediators of tolerance to infection and support a therapeutic strategy based on repurposing clinically available {beta}3-adrenergic agonists to improve outcomes in sepsis. One Sentence SummaryWhite adipose tissue lipolysis promotes metabolic tolerance to infection through circulating fatty acids and is associated with improved survival in sepsis

Aging is a major risk factor for joint disease, yet the impact of physiological aging on the synovium remains poorly defined. Here we generate a single-cell atlas of murine ankle synovium across age and identify the sublining stromal-myeloid niche as a major site of age-associated remodeling. Aging shifted fibroblast states toward oxidative stress and matrix-remodeling programs, accompanied by sublining collagen accumulation, reduced cellularity, and loss of THY1+ sublining fibroblasts. In parallel, resident synovial macrophages exhibited altered inflammatory and phagocytic responses together with a preferential decline in TIM4+VSIG4- sublining macrophages, without overt local myeloid expansion despite systemic inflammaging. Macrophage depletion experiments further supported a link between sublining macrophages and extracellular matrix homeostasis. Together, these findings provide a reference framework for synovial aging and uncover niche-specific stromal and macrophage alterations associated with aging.

Rheumatoid arthritis (RA) is a heritable and common autoimmune condition. To date, most genetic associations were derived from individuals with either European or East Asian ancestries. Here, we applied a multimodal automated phenotyping strategy to define RA and performed a genome-wide association study (GWAS) of RA in the Million Veteran Program (MVP), including underrepresented African American (AFR) and Admixed American (AMR) populations. Meta-analyses with previous RA cohorts identified 152 autosomal genome-wide significant loci, of which 31 were novel. Inclusion of multi-ancestry data dramatically improved fine-mapping resolution. Functional characterization of these loci using single-cell transcriptomic and chromatin data suggested new RA genes such as CHD7 and CD247. We identified underappreciated functional roles of fine-grained immune cell states other than T cells, such as B cell and myeloid cell states. We observed that multi-ancestry polygenic risk scores using our data demonstrated better predictive ability, especially for AFR and AMR populations.

Cerebral malaria is a severe neurological complication of Plasmodium falciparum infection. Damage of the blood-brain barrier (BBB) and endothelial dysfunction are established drivers of the disease pathology, however, whether astrocytes, a major constituent of the BBB, influence the disease outcome remains unclear. Using the murine model of experimental cerebral malaria (ECM), we show that astrocytes decisively regulate the outcome of ECM and the deubiquitinating enzyme OTUD7B in astrocytes fosters the disease. Mice lacking astrocytic OTUD7B showed reduced brain pathology and were protected from ECM compared with wildtype littermate controls. Transcriptomic profiling of ex vivo-isolated astrocytes revealed reduced proinflammatory chemokines and cytokines in the absence of OTUD7B. Plasmodium infection-associated microvesicles triggered a pro-inflammatory response in astrocytes, which was dependent on OTUD7B. Mechanistically, OTUD7B cleaved K48-linked ubiquitin chains from TRAF3 and TRAF6 upon stimulation with microvesicles or activation of TLR3/TLR9 by plasmodial nucleic acids. The OTUD7B-dependent TRAF3 and TRAF6 stabilization led to sustained NF-{kappa}B and p38 MAP kinase signaling and CXCL10 expression. Therapeutic silencing of CNS Otud7b or Cxcl10 expression after disease onset protected mice from ECM, identifying the cerebral OTUD7B-Cxcl10 axis as an attractive therapeutic target.

NLRP3 is an innate immune sensor of a broad range of stimuli, which upon activation forms a multiprotein inflammasome complex triggering caspase-1 activation, IL-1{beta} and IL-18 maturation, and inflammatory cell death. The canonical NLRP3 activation pathway has been well characterized from a structural perspective. It involves the association of NLRP3 with membranes in the form of inactive oligomeric "cage" complexes, which, upon activation, convert to an active oligomeric NLRP3 disc. NLRP3 structural rearrangements during non-classical NLRP3 activation pathways, however, remain unknown. Here, we report a novel mode of NLRP3 activation utilized by the NLRP3 homolog from zebrafish. The cryo-EM structure of zebrafish NLRP3 shows that, unlike human NLRP3, it forms disc-shaped heptamers that undergo further trimerization, resulting in a 21-mer oligomeric arrangement. Surprisingly, a single zebrafish NLRP3 heptamer cannot arrange its PYD domains into a PYD helix and therefore requires a trimer of heptamers to form a PYD filament that enables ASC oligomerization. Furthermore, zebrafish NLRP3 does not associate with the Golgi network, nor does it form inactive "cage" oligomers or interact with NEK7. Thus, our data demonstrate an ancestral non-canonical structural mechanism of NLRP3 activation, which may shed light on alternative NLRP3 activation pathways present in humans.

Proteome-wide association studies (PWAS) typically link genetically predicted protein levels to disease using cis-pQTLs, which can be limited by low cis-heritability for disease-critical genes under negative selection and by tagging due to co-regulation among nearby genes. Trans-pQTLs provide complementary information when large sample sizes are available to detect weak polygenic effects, enabling associations between trans-predicted protein levels and disease. We developed PolyPWAS, a functionally informed, summary statistics-based framework for associating both cis- and trans-predicted protein levels to disease. PolyPWAS integrates 96 functional annotations with proteome-wide pleiotropy to improve protein prediction, while correcting for PCs of predicted protein levels to limit tagging effects. We applied PolyPWAS to 2.8K plasma proteins measured in 34K UKB-PPP participants, analyzing GWAS summary statistics for 88 diseases and complex traits (average N=336K). Trans-predicted protein levels explained 21% of disease heritability (vs. 9.6% for cis-predicted protein levels), leveraging a 24% relative improvement in trans-prediction accuracy from functional priors. Trans-PWAS identified more significant protein-disease associations (and more conditionally significant associations) than cis-PWAS. Cis and trans associations showed only modest excess overlap (1.18, 95% CI: 1.11-1.26). Accordingly, combining evidence from cis and trans associations improved disease gene prioritization evaluated using gene sets from rare variant association studies (+11% relative improvement) and PoPS (+7.0% relative improvement) relative to cis-only approaches. PWAS associations to disease replicated across protein level cohorts, with strong UKB-PPP/deCODE concordance after adjusting for cohort-specific prediction accuracy. We provide examples where trans-regulatory effects link multiple disease-critical genes, underscoring the importance of integrating cis- and trans-regulatory effects to map protein-mediated disease biology.

Microglia, the resident macrophages of the central nervous system, are recognized for their heterogeneity and integral role in brain function and diseases. In the context of high fat diet (HFD) feeding and obesity, microglia become overactive, acquiring a prevailing lipid associated microglial phenotype (also known as LAM). Yet, how microgliosis is induced and regulated remains unclear. Here we report a key role for the Complement 3a Receptor (C3aR), on HFD-induced hypothalamic gliosis and weight gain in mice. HFD consumption leads to elevated microglial expression of C3aR, which parallels widespread accumulation of reactive microglia, selectively in the hypothalamus. Conditional microglial C3aR deletion protects mice from HFD-induced hypothalamic reactive microgliosis. C3aR deletion or pharmacological antagonism opposes HFD-induced weight gain in male but not female mice. Mechanistically, we demonstrated that C3aR is essential for lipid-induced lipid droplet formation, and acquisition of a LAM molecular signature. In summary, we uncovered a previously unknown role for C3aR in the acquisition of a LAM signature driving diet-induced gliosis, identifying this receptor as a new viable therapeutic candidate for conditions associated with hypothalamic neuroinflammation.

Metabolic remodeling is a hallmark of cardiomyopathy, yet which cell types bear the metabolic burden and how cell-type-specific contributions are disrupted remain unclear. Here, we developed a cell-type-resolved genome-scale metabolic flux inference pipeline optimized for post-mitotic cardiac tissue by maximizing ATP synthesis rather than biomass production and applied it to a single-nucleus transcriptomic atlas of human cardiomyopathies (78 donors, 869,449 nuclei). Metabolic impairment in dilated cardiomyopathy (DCM) was most profound in stromal cells, whereas myeloid cells exhibited opposing metabolic activation. DCM- associated impairment followed a genotype-dependent severity gradient from structural gene mutations to pathogenic variant-negative (PVneg) cases. PVneg hearts uniquely harbored 24 altered metabolic pathways not significant in any other genotype. These PVneg-specific signatures were independent of clinical severity, indicating a genotype-intrinsic metabolic program. Extending the analysis to arrhythmogenic cardiomyopathy and hypertrophic cardiomyopathy showed that ATP depletion is shared across cardiomyopathy subtypes, whereas metabolic remodeling differed across disease subtypes. Additionally, gene regulatory network analysis linked these alterations to broad transcription factor (TF) dysregulation and pervasive TF-metabolic coupling across all cell types. These findings redefine PVneg DCM as a metabolically distinct entity and reveal conserved stromal metabolic remodeling across cardiomyopathies, providing a framework for genotype-informed mechanistic stratification.

Allogeneic hematopoietic stem cell transplantation (HSCT) is a life-saving treatment for hematologic malignancies, but long-term survivors present with lower muscle mass and functional capacity. In adult HSCT survivors 10-20 years after treatment, single nucleus RNA sequencing uncovered elevated XRRA1 expression levels in all muscle nuclei populations, which was retained in primary muscle stem cell cultures. HSCT survivors were characterized in vivo by impaired neuromuscular innervation that associated with muscle weakness, and lower muscle stem cell neurotrophic action. Despite these impairments, the molecular and physiological responses to heavy resistance training (HReT) were preserved in HSCT survivors, as demonstrated in a pre-registered clinical trial (ClinicalTrials.gov: NCT04922970). After 12 weeks of HReT, gains in muscle mass and strength were similar in HSCT survivors and healthy controls. In addition, we observed that [~]9% of muscle-resident immune cells persist into adulthood and that bone marrow derived cells do not adopt alternative cell fates in muscle tissue, resolving long-standing questions in human muscle biology. Together, these findings uncover molecular mechanisms of HSCT sequelae in muscle nuclei and muscle stem cells, which, importantly, can at least partly be overcome by mechanical loading. Given the growing population of HSCT survivors and the multitude of benefits of HReT for all organ systems, our findings support the importance of HReT in this population to promote healthspan.

Serological diagnostics traditionally rely on pathogen-derived antigens to detect infection-specific antibody responses. Chronic infections also induce systemic immune remodeling that may be reflected in global antibody reactivity patterns beyond antigen specificity. Here we evaluate a dual-layer serological framework combining HIV-derived peptides with a host-derived peptide library designed to capture distributed antibody reactivity patterns. Using strict nested cross-validation in a cohort of 105 individuals, pathogen-derived 12-mer peptides achieved high classification performance with an AUC of 0.891, whereas the 10-mer host-based peptide library alone yielded moderate but statistically significant discrimination with an AUC of 0.805. Integration via regularized stacking resulted in only a modest additive improvement, reaching an AUC of 0.897, indicating partial redundancy in diagnostic ranking. In contrast, entropy and inequality analyses revealed substantial immune repertoire restructuring in HIV-positive individuals, characterized by reduced Shannon entropy and significant correlations between classifier probability and repertoire concentration. These findings support a dual-layer model of serology in which the integration of pathogen-derived and host-derived peptides into a meta model encode antigen specificity, whereas host-reactive signatures reflect systemic immune topology. Distinguishing diagnostic ranking from immune-state encoding provides a conceptual framework for multi-layer serological diagnostics.