COL1A1-Enhanced CD44/SLC7A11 Interaction and Cystine Uptake Result in CD34 <sup>+</sup> Foam-Like Macrophage Accumulation in Transplant Arteriosclerosis

J Junru Wu (College of Materials Science and Engineering Fuzhou University Fuzhou China) T Tian He (Department of Molecular and Medical Pharmacology, University of California) M Mengyao Qi (Clinical Research Center, Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.W., M.Q., M.Y., X.Z., Q.Z., W.Z., X.H., Y.L., Y.G., T.S., C.W., L.P., Y.L., H.Y., J.C.).) L Liang Chen M Meng Yao (State Key Laboratory of Advanced Chemical Power Sources, Key Laboratory of Advanced Energy Materials Chemistry (Ministry of Education), Engineering Research Center of High-efficiency Energy Storage (Ministry of Education), Frontiers Science Center for New Organic Matter (Ministry of Education), College of Chemistry) X Xiexiong Zhao Q Qiaoyu Zhou (Clinical Research Center, Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.W., M.Q., M.Y., X.Z., Q.Z., W.Z., X.H., Y.L., Y.G., T.S., C.W., L.P., Y.L., H.Y., J.C.).) W Wen Zhang X Xuewei Huang (CAS Key Laboratory of Nanosystem and Hierarchical Fabrication & CAS Center for Excellence in Nanoscience) Y Yuqing Liu (State Key Laboratory of Electronic Thin Films and Integrated Devices) Y Yingxuan Gong (Clinical Research Center, Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.W., M.Q., M.Y., X.Z., Q.Z., W.Z., X.H., Y.L., Y.G., T.S., C.W., L.P., Y.L., H.Y., J.C.).) T Tianrui Shi (Clinical Research Center, Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.W., M.Q., M.Y., X.Z., Q.Z., W.Z., X.H., Y.L., Y.G., T.S., C.W., L.P., Y.L., H.Y., J.C.).) Y Yun Hong H Hang Gao C Chunyan Weng L Liping Peng Q Qingzhong Xiao (Centre for Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK (Q.X.).) Y Yao Lu H Hong Yuan (Clinical Laboratory Center, Central Hospital of Dalian University of Technology) Q Qingbo Xu J Jingjing Cai

Abstract

BACKGROUND: Chronic transplant arteriosclerosis is the primary cause of long-term graft failure. Selectively targeting specific inflammatory macrophage subpopulations is essential for inhibiting the primary triggers of inflammatory and immune responses. Therefore, elucidating the origins and regulatory mechanisms of these macrophages in allograft arteriosclerosis is key for the development of targeted therapies. METHODS: We performed single-cell RNA sequencing and spatial transcriptomics or integrated transcriptomic data from human chronic allograft vasculopathy specimens and mouse vascular allograft models. Flow cytometry and immunofluorescence staining were used to characterize macrophage subpopulations within remodeled allograft arteries. To determine cellular origins, CD34 + lineage tracing and depletion strategies were used. The interactions among COL1A1 (collagen type 1 α1), CD44, and SLC7A11 (solute carrier family 7 member 11) were analyzed using proximity ligation assays and coimmunoprecipitation. Furthermore, metabolic profiles were investigated with ultraperformance liquid chromatography coupled with high-resolution mass spectrometry. To validate the role of cystine transport in macrophage differentiation, we used pharmacologic inhibitors and a genetic approach using myeloid-specific Slc7a11 knockout mice (Lysm- Slc7a11 -KO). The mechanisms identified in vivo were further corroborated through in vitro experiments. RESULTS: We identified a novel proinflammatory foam-like macrophage phenotype in allograft arterial adventitia. These macrophages primarily originated from bone marrow–derived CD34 + lineage cells and exhibit heightened de novo lipogenesis and proinflammatory activity. Their lipogenesis is driven by increased cystine uptake, facilitated by enhanced membrane expression of the CD44–SLC7A11 complex, which activates mTORC1 (mechanistic target of rapamycin complex 1)–HIF-1α (hypoxia-inducible factor 1α) signaling. We also revealed that fibroblast-secreted COL1A1 is essential for anchoring the complex to the cell membrane through its direct interaction with CD44. Blocking COL1A1, CD44, or SLC7A11 effectively attenuated mTORC1–HIF-1α signaling, inflammation, and lipogenesis in macrophages as well as accumulation of foam-like cells and intimal hyperplasia in allograft arteries. CONCLUSIONS: This study has revealed previously uncharacterized foam-like macrophages in transplant arteriosclerosis, with COL1A1-enhanced amino acid metabolism modulating lipogenesis and foamy macrophage formation. This study offers potential therapeutic targets to modulate immune response and enhance transplant outcomes.

Article Details

Journal Circulation
Volume / Issue Vol. 1, Issue 1
Published August 04, 2026
ISSN 0009-7322
Publisher Lippincott Williams & Wilkins

Journal Info

Circulation

Lippincott Williams & Wilkins

ISSN: 0009-7322 Health Sciences

Authors (21)

J

Junru Wu

College of Materials Science and Engineering Fuzhou University Fuzhou China

T

Tian He

Department of Molecular and Medical Pharmacology, University of California

M

Mengyao Qi

Clinical Research Center, Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.W., M.Q., M.Y., X.Z., Q.Z., W.Z., X.H., Y.L., Y.G., T.S., C.W., L.P., Y.L., H.Y., J.C.).

L

Liang Chen

M

Meng Yao

State Key Laboratory of Advanced Chemical Power Sources, Key Laboratory of Advanced Energy Materials Chemistry (Ministry of Education), Engineering Research Center of High-efficiency Energy Storage (Ministry of Education), Frontiers Science Center for New Organic Matter (Ministry of Education), College of Chemistry

X

Xiexiong Zhao

Q

Qiaoyu Zhou

Clinical Research Center, Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.W., M.Q., M.Y., X.Z., Q.Z., W.Z., X.H., Y.L., Y.G., T.S., C.W., L.P., Y.L., H.Y., J.C.).

W

Wen Zhang

X

Xuewei Huang

CAS Key Laboratory of Nanosystem and Hierarchical Fabrication & CAS Center for Excellence in Nanoscience

Y

Yuqing Liu

State Key Laboratory of Electronic Thin Films and Integrated Devices

Y

Yingxuan Gong

Clinical Research Center, Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.W., M.Q., M.Y., X.Z., Q.Z., W.Z., X.H., Y.L., Y.G., T.S., C.W., L.P., Y.L., H.Y., J.C.).

T

Tianrui Shi

Clinical Research Center, Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.W., M.Q., M.Y., X.Z., Q.Z., W.Z., X.H., Y.L., Y.G., T.S., C.W., L.P., Y.L., H.Y., J.C.).

Y

Yun Hong

H

Hang Gao

C

Chunyan Weng

L

Liping Peng

Q

Qingzhong Xiao

Centre for Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK (Q.X.).

Y

Yao Lu

H

Hong Yuan

Clinical Laboratory Center, Central Hospital of Dalian University of Technology

Q

Qingbo Xu

J

Jingjing Cai