Evidence mapPaperPMID 42433374Full record

ArticleFrontiers in immunology2026

From islet to blood: macrophage remodeling signatures for diagnosis and risk stratification in type 1 diabetes.

Yang Chen, Yiwen Zhou, Shuang Li, Yulu Chen, Jingfei Liu, Chun Yang, Hang Zhao, Zhangyao Su, Lingling Bian, Shuang Chen and 8 more

Abstract read
In one paragraph

Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Yang Chen *Department of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Yiwen Zhou *Department of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Shuang Li *Department of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Yulu ChenDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Jingfei LiuDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Chun YangDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Hang ZhaoDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Zhangyao SuDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Lingling BianDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Shuang ChenDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Min ShenDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Yao QinDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Heng ChenDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Xinyu XuDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Yun ShiDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Mei ZhangDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Tao YangDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Yong GuDepartment of Endocrinology & Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.

Funding

The Human Pancreas Analysis Program for Type 2 DiabetesU01DK123594 · NIDDK · UNIVERSITY OF PENNSYLVANIA · 2022 to 2025
$8.0M
Human Pancreas Analysis Program-T2DU01DK123716 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI MARK A. ATKINSON, Rita Bottino · 2022 to 2022
$1.1M
NIDDK NIH HHS U01 DK123594NIDDK NIH HHS U01 DK123716NIDDK NIH HHS UC4 DK112217NIDDK NIH HHS UC4 DK112232
6 · The paper itself

Abstract

Background: Type 1 diabetes (T1D) is an autoimmune disease characterized by progressive β-cell destruction, yet current risk stratification tools, which rely mainly on genetic susceptibility and autoantibody profiles, remain insufficient for accurately predicting disease progression. We aimed to characterize macrophage-related inflammatory transcriptional activity in T1D and to develop peripheral blood-based biomarkers for diagnosis and risk stratification. Methods: We integrated bulk RNA-seq, single-cell RNA-seq, and spatial transcriptomic data from human islets with public and in-house peripheral blood transcriptomic datasets. Macrophage heterogeneity and remodeling trajectories were analyzed in the islet microenvironment, and machine learning was used to derive tissue- and blood-based proinflammatory macrophage-related genes (PMRG). Diagnostic and prognostic models were then constructed and validated in peripheral blood cohorts, including a longitudinal islet autoimmunity (IA) cohort. SHAP analysis was applied to improve model interpretability. Independent PBMC RT-qPCR and mouse pancreatic immunofluorescence were performed to validate selected PMRG-related genes. Results: T1D islets showed marked immune remodeling with myeloid enrichment and five distinct macrophage subtypes. Pseudotime analysis identified a pro-inflammatory macrophage trajectory and 265 PMRGs, from which a 9-gene islet-derived PMRG (iPMRG) was obtained. Spatial transcriptomics supported the association of iPMRG-high macrophage signals with disrupted β-cell regions, and CellChat analysis inferred altered inflammatory communication programs. In peripheral blood mononuclear cells (PBMCs), the iPMRG-based diagnostic classifier distinguished T1D from healthy controls with an optimism-corrected AUC of 0.736. For prognosis, a 15-gene prognostic PMRGs was used to construct a risk score that, when integrated with clinical variables, predicted progression from IA to clinical T1D with time-dependent AUCs of 0.825, 0.814, and 0.860 at 12, 36, and 60 months, respectively. SHAP analysis identified the PMRG risk score as the dominant predictor and highlighted six core driver genes (PID1, TFPI2, SERPINB2, SOX4, DUSP2, and MT1X). The computational findings were further supported by independent validation in PBMCs and mouse pancreatic tissues. Conclusions: Our study highlights the heterogeneous and dynamic nature of macrophage remodeling in the T1D islet microenvironment, which is translated into accessible peripheral blood signatures. The resulting diagnostic and prognostic models provide an interpretable framework for T1D risk stratification and may support future strategies for earlier detection and precision prevention.

Indexed as

Diabetes Mellitus, Type 1Islets of LangerhansMacrophagesAnimalsAutoimmunityBiomarkersFemaleGene Expression ProfilingHumansMaleMiceRisk AssessmentTranscriptomeBiomarkersbiomarkerislet autoimmunitymachine learningmacrophage remodelingperipheral blood (PB)risk stratificationsingle-cell RNA sequencing (scRNA seq)type 1 diabetes (T1D)

Identifiers

PMID42433374
PMCPMC13350049

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.