Loss of CXCR5 expression and monocyte epithelial–mesenchymal transition are blood‐borne signatures of sterile granulomatous diseases

Abstract Objectives Sarcoidosis is the exemplar sterile granulomatous disease and can affect any organ system. Tattoo uveitis (TU) resembles sarcoidosis clinically and histologically but is distinguished by the absence of systemic lymphadenopathy, with inflammation restricted to skin and eyes. In th...

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Main Authors: Yuwei Hao, Anthea Anantharajah, Jane M Wells, Lyndell L Lim, Anthony JH Hall, Gary YJ Chew, Matthew C Cook
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Clinical & Translational Immunology
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Online Access:https://doi.org/10.1002/cti2.70039
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author Yuwei Hao
Anthea Anantharajah
Jane M Wells
Lyndell L Lim
Anthony JH Hall
Gary YJ Chew
Matthew C Cook
author_facet Yuwei Hao
Anthea Anantharajah
Jane M Wells
Lyndell L Lim
Anthony JH Hall
Gary YJ Chew
Matthew C Cook
author_sort Yuwei Hao
collection DOAJ
description Abstract Objectives Sarcoidosis is the exemplar sterile granulomatous disease and can affect any organ system. Tattoo uveitis (TU) resembles sarcoidosis clinically and histologically but is distinguished by the absence of systemic lymphadenopathy, with inflammation restricted to skin and eyes. In this study, our objectives were, first, to resolve whether TU is a subset of sarcoidosis or a different antigen‐driven condition and, second, by comparing TU and sarcoidosis, to identify blood‐borne signatures of active and quiescent sterile granulomatous diseases. Methods We recruited patients with active and inactive TU, sarcoidosis and healthy controls on whom we performed blood cell phenotyping and transcriptomics. Results Unlike sarcoidosis, active TU is characterised by marked CXCR5 down‐regulation on B cells and CD4+ T cells that normalises on remission. TCR‐VDJ sequencing reveals an antigen‐driven response in sarcoidosis, but not in TU, with clonally expanded cytotoxic and terminally differentiated CD8+ effectors. Both active TU and sarcoidosis exhibit gene signatures of epithelial‐to‐mesenchymal transition (EMT) in circulating monocytes, whereas epithelioid macrophages are a hallmark of active granulomas. Conclusion We have identified both shared and specific phenotypes in TU and sarcoidosis. Marked CXCR5 down‐regulation occurs in active TU and could explain the unique absence of lymphadenopathy. Both TU and sarcoidosis are characterised by inflammatory monocyte phenotypes and transcriptional signatures of EMT.
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spelling doaj-art-2a645c70a5494fa09f2c4b6ea6c8ee012025-06-24T23:08:44ZengWileyClinical & Translational Immunology2050-00682025-01-01146n/an/a10.1002/cti2.70039Loss of CXCR5 expression and monocyte epithelial–mesenchymal transition are blood‐borne signatures of sterile granulomatous diseasesYuwei Hao0Anthea Anantharajah1Jane M Wells2Lyndell L Lim3Anthony JH Hall4Gary YJ Chew5Matthew C Cook6Division of Immunology and Infectious Diseases, John Curtin School of Medical Research Australian National University Canberra ACT AustraliaDivision of Immunology and Infectious Diseases, John Curtin School of Medical Research Australian National University Canberra ACT AustraliaDepartment of Ophthalmology The Canberra Hospital Canberra ACT AustraliaRoyal Victorian Eye and Ear Hospital Melbourne VIC AustraliaDepartment of Ophthalmology Alfred Hospital Melbourne VIC AustraliaDepartment of Immunology The Canberra Hospital Canberra ACT AustraliaDivision of Immunology and Infectious Diseases, John Curtin School of Medical Research Australian National University Canberra ACT AustraliaAbstract Objectives Sarcoidosis is the exemplar sterile granulomatous disease and can affect any organ system. Tattoo uveitis (TU) resembles sarcoidosis clinically and histologically but is distinguished by the absence of systemic lymphadenopathy, with inflammation restricted to skin and eyes. In this study, our objectives were, first, to resolve whether TU is a subset of sarcoidosis or a different antigen‐driven condition and, second, by comparing TU and sarcoidosis, to identify blood‐borne signatures of active and quiescent sterile granulomatous diseases. Methods We recruited patients with active and inactive TU, sarcoidosis and healthy controls on whom we performed blood cell phenotyping and transcriptomics. Results Unlike sarcoidosis, active TU is characterised by marked CXCR5 down‐regulation on B cells and CD4+ T cells that normalises on remission. TCR‐VDJ sequencing reveals an antigen‐driven response in sarcoidosis, but not in TU, with clonally expanded cytotoxic and terminally differentiated CD8+ effectors. Both active TU and sarcoidosis exhibit gene signatures of epithelial‐to‐mesenchymal transition (EMT) in circulating monocytes, whereas epithelioid macrophages are a hallmark of active granulomas. Conclusion We have identified both shared and specific phenotypes in TU and sarcoidosis. Marked CXCR5 down‐regulation occurs in active TU and could explain the unique absence of lymphadenopathy. Both TU and sarcoidosis are characterised by inflammatory monocyte phenotypes and transcriptional signatures of EMT.https://doi.org/10.1002/cti2.70039CXCR5granulomasarcoidosistattoouveitis
spellingShingle Yuwei Hao
Anthea Anantharajah
Jane M Wells
Lyndell L Lim
Anthony JH Hall
Gary YJ Chew
Matthew C Cook
Loss of CXCR5 expression and monocyte epithelial–mesenchymal transition are blood‐borne signatures of sterile granulomatous diseases
Clinical & Translational Immunology
CXCR5
granuloma
sarcoidosis
tattoo
uveitis
title Loss of CXCR5 expression and monocyte epithelial–mesenchymal transition are blood‐borne signatures of sterile granulomatous diseases
title_full Loss of CXCR5 expression and monocyte epithelial–mesenchymal transition are blood‐borne signatures of sterile granulomatous diseases
title_fullStr Loss of CXCR5 expression and monocyte epithelial–mesenchymal transition are blood‐borne signatures of sterile granulomatous diseases
title_full_unstemmed Loss of CXCR5 expression and monocyte epithelial–mesenchymal transition are blood‐borne signatures of sterile granulomatous diseases
title_short Loss of CXCR5 expression and monocyte epithelial–mesenchymal transition are blood‐borne signatures of sterile granulomatous diseases
title_sort loss of cxcr5 expression and monocyte epithelial mesenchymal transition are blood borne signatures of sterile granulomatous diseases
topic CXCR5
granuloma
sarcoidosis
tattoo
uveitis
url https://doi.org/10.1002/cti2.70039
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