PloS one
Peripheral blood transcriptomes and a single-cell atlas suggest a monocyte-associated immune recovery-failure axis in STEMI
By Cheng Q, Li Q and Yin D.
Abstract
Background
Patients with ST-segment elevation myocardial infarction (STEMI) continue to show substantial inflammatory heterogeneity after reperfusion therapy, and recovery trajectories may differ markedly across patients. Compared with traditional diagnostic models, characterizing the dynamic immune trajectory from acute inflammation toward recovery may better identify programs associated with impaired resolution. This study aimed to construct an immune recovery-failure framework that is transferable across cohorts and anchored by single-cell data.
Methods
We integrated six public GEO peripheral-blood bulk transcriptome cohorts and one public single-cell RNA-seq dataset. An acute-to-recovery immune axis was constructed from directionally concordant longitudinal and cross-sectional contrasts, and a recovery-failure phenotype was defined in the discovery longitudinal cohort from paired transcriptomic features. An 18-gene monocyte-associated module was then derived using bulk recovery-failure associations, monocyte specificity, monocyte-state differences, and pseudotime information. External cohorts were used to evaluate temporal transfer and baseline-to-follow-up associations rather than definitive clinical prediction, and the single-cell dataset was used for donor-aware cell-type anchoring and exploratory state-level interpretation.
