Single-cell analysis links immune microenvironment remodeling to S1PR1/S1PR4-mediated peritoneal fibrosis in long-term peritoneal dialysis

 

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Single-cell analysis links immune microenvironment remodeling to S1PR1/S1PR4-mediated peritoneal fibrosis in long-term peritoneal dialysis

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Qiuyuan
Shao
Qiuyuan Shao qiuyshao@163.com Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Department of Nephrology Nanjing China *
Ying Liu glyyskl@163.com Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Department of Nephrology Nanjing China -
Yuan Feng fengyuannj@163.com Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Department of Nephrology Nanjing China -
Yangyang Xia 574360937@qq.com Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Department of Nephrology Nanjing China -
Qingyan Zhang zqy9912@163.com Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Department of Nephrology Nanjing China -
Cheng Wan wancheng126@163.com Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Department of Nephrology Nanjing China -
Chunming Jiang guloujiang@sina.com Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Department of Nephrology Nanjing China -
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Long-term peritoneal dialysis (PD) often leads to peritoneal dysfunction, among which peritoneal fibrosis is particularly common; however, the molecular mechanisms underlying the association between long-term PD induced immune dysregulation and the progression of peritoneal fibrosis remain unclear.

This study integrated multi-omics analyses (including single-cell RNA sequencing and bulk transcriptome sequencing) with experimental validation. An in vitro peritoneal fibrosis model was established by treating human peritoneal mesothelial cells (MeT-5A cells) with transforming growth factor-β1 (TGF-β1). Quantitative real-time polymerase chain reaction (qPCR) and western blot (WB) were used to detect the expression levels of hub genes (S1PR1/S1PR4, namely sphingosine-1-phosphate receptor 1/4) in both cellular samples and clinical samples. The functional role of S1PR4 was verified through gene overexpression and knockdown experiments.

Single-cell sequencing results showed that long-term PD led to a significant decrease in the proportion of natural killer T (NKT) lymphocytes and remodeled the peritoneal immune microenvironment. Integrated transcriptomic analysis further identified S1PR1/S1PR4 as the hub genes closely associated with this process. Experimental validation demonstrated that S1PR1 and S1PR4 were highly expressed in both the peritoneal tissues of patients undergoing long-term PD and in TGF-β1-induced fibrotic cells, and crucially, that modulation of S1PR4 directly regulated fibrosis markers.

This study suggests that, in long-term PD, the dysregulation of the immune microenvironment -characterized by a reduction in NKT cells - may drive the occurrence and progression of peritoneal fibrosis by upregulating the S1PR1/S1PR4 signaling pathways involving S1PR4. It indicates that S1PR1/S1PR4 are potential therapeutic targets for alleviating peritoneal injury and improving the long-term prognosis of PD patients.

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