Dermal macrophages acquire a TREM2-anchored profibrotic state in antiphospholipid syndrome that is reflected in the circulation

Dermal macrophages in primary antiphospholipid syndrome acquire a TREM2-anchored lipid-associated profibrotic program, linked to increased soluble TREM2 and osteopontin in plasma.

• Why it matters: Chronic microvascular disease in APS can impair renal and other organ function, but the tissue-resident immune programs driving this remain unclear.
• What they did: Single-cell profiling of dermal tissue from 30 primary APS patients and 14 matched healthy controls identified myeloid transcriptional states and predicted macrophage–stromal communication networks, including TREM2 macrophages.
• The result: The dermal TREM2 program correlated positively with plasma soluble TREM2 and osteopontin and inversely with estimated glomerular filtration rate, and soluble TREM2 was higher in APS patients with suspected or established nephropathy.

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