journal article·2025-11Open access

Deciphering the Role and Mechanism of Decidual Monocyte‐Derived Macrophage Infiltration in Obstetric Antiphospholipid Syndrome at Single‐Cell Resolution

Rui Gao, Pingying Qing, Hanxiao Chen, Zhengyan Hu, Qiaoran Yang, Chenyang Lu, Huimin Liu, Rujun Zeng, Yuanting Tang, Fan Yu, Jinbiao Han, Xin Liao, Xun Zeng, Lang Qin

Advanced Science· Volume 12· Issue 41

Abstract

Abstract Obstetric antiphospholipid syndrome (OAPS) is an autoimmune disorder characterized by pathologic pregnancies and the presence of antiphospholipid antibodies (aPLs). Despite significant infiltration of decidual macrophages observed in OAPS patients, the underlying connections between decidual and peripheral immune cells remain unclear. In this study, an integrated single‐cell atlas is constructed of the decidua and peripheral blood mononuclear cells (PBMCs) from OAPS patients and HCs. Using this atlas, substantial disparities are identified in immune cells between the decidua and PBMCs. The functional changes in immune cells of OAPS patients are also different in decidua and PBMCs. Moreover, increased infiltration of monocyte‐derived macrophages (MDMs) into the decidua is found to contribute to inflammation and trophoblast dysfunction in OAPS. The role of CCL2 is further discovered in recruiting MDMs, driven by excess CCL2 secreted from decidual macrophages stimulated by the aPLs and β 2 ‐glycoprotein I complex via the TLR4‐NF‐κB pathway. Decidual vascular endothelial cells express higher levels of ACKR1, which aggregates CCL2 on their surface. Targeting CCR2 and TLR4 improved pregnancy outcomes in OAPS mouse models induced by aPLs, suggesting that these pathways may serve as potential therapeutic targets for OAPS. This study provides new insights into the pathogenesis of OAPS, particularly regarding decidual MDMs infiltration.
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Research context

OpenAlex topics: Systemic Lupus Erythematosus Research · Reproductive System and Pregnancy · Immune Response and Inflammation

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Reproductive Medical Center, Department of Obstetrics and Gynecology West China Second University Hospital, Sichuan University Chengdu 610041 China

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education West China Second University Hospital, Sichuan University Chengdu 610041 China

Department of Rheumatology and Immunology, West China Hospital Sichuan University Chengdu 610041 China

Department of Obstetrics and Gynecology, West China Second University Hospital Sichuan University Chengdu 610041 China

Key Laboratory of Drug‐Targeting and Drug Delivery System of the Education Ministry, Sichuan Engineering Laboratory for Plant‐Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology West China School of Pharmacy Sichuan University Chengdu 610064 China

Division of Rheumatology, Department of Internal Medicine, The Third Affiliated Hospital Sun Yet‐Sen University Guangzhou 510665 China

Department of Laboratory Medicine, West China Second University Hospital Sichuan University Chengdu 610041 China

Department of the Central Operating Unit, West China Second University Hospital/West China School of Nursing Sichuan University Chengdu 610041 China

Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, West China Second University Hospital Sichuan University Chengdu 610041 China

Funding

Science and Technology Department of Sichuan Province

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