Cited by 29Cardiac Fibrosis and RemodelingCongenital heart defects researchMesenchymal stem cell research

Pro-Fibrotic Macrophage Subtypes: SPP1+ Macrophages as a Key Player and Therapeutic Target in Cardiac Fibrosis?

Open access
Uhlig, Moritz, Billig, Sebastian, Wienhold, Jan, Schumacher, David·2025·Cells

Abstract

Cardiac fibrosis is a major driver of heart failure, a leading cause of morbidity and mortality worldwide. Advances in single-cell transcriptomics have revealed the pivotal role of SPP1+ macrophages in the pathogenesis of cardiac fibrosis, positioning them as critical mediators and promising therapeutic targets. SPP1+ macrophages, characterized by elevated expression of secreted phosphoprotein 1 (SPP1) and often co-expressing Triggering Receptor Expressed on Myeloid Cells 2 (TREM2), localize to fibrotic niches in the heart and other organs. These cells interact with activated fibroblasts and myofibroblasts, driving extracellular matrix remodeling and fibrosis progression. Their differentiation is orchestrated by signals such as CXCL4, GM-CSF, and IL-17A, further emphasizing their regulatory complexity. Therapeutic strategies targeting SPP1+ macrophages have shown encouraging preclinical results. Approaches include silencing Spp1 using antibody–siRNA conjugates and modulating key pathways involved in macrophage differentiation. These interventions have effectively reduced fibrosis and improved cardiac function in animal models. The mechanisms underlying SPP1+ macrophage function in cardiac fibrosis provide a foundation for innovative therapies aimed at mitigating pathological remodeling and improving outcomes in patients with heart failure. This emerging field has significant potential to transform the treatment of fibrotic heart disease.

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Crossref · 10.3390/cells14050345

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  • Myocarditis is not only a transient inflammatory condition but a highly orchestrated process involving temporally regulated immune-stromal interactions that critically determine disease outcome.

    “Our findings support and extend previous observations that myocarditis is not only a transient inflammatory condition but a highly orchestrated process involving temporally regulated immune–stromal interactions that critically determine the outcome of the disease [9,30].”

    From Cardiac Macrophages Exhibit Dynamic Heterogeneity and Functional Specialization During Experimental Autoimmune Myocarditis. (2026) · cites this paper as [30]

    The Introduction (section 1; page unavailable) describes macrophages influencing fibrogenesis through mesenchymal cells and links maladaptive fibrosis to organ failure. Section 4 also describes inflammatory and reparative macrophage activity after injury. These passages support a role for immune–stromal interactions in cardiac outcomes, but they do not establish the claim specifically for myocarditis or describe temporally regulated interactions determining its outcome. (LLM, conf=0.82)

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  • SPP1-expressing macrophages have emerged as a conserved pro-fibrotic population across human inflammatory cardiomyopathies.

    “while SPP1-expressing macrophages have emerged as a conserved pro-fibrotic population across human inflammatory cardiomyopathies [30].”

    From Cardiac Macrophages Exhibit Dynamic Heterogeneity and Functional Specialization During Experimental Autoimmune Myocarditis. (2026) · cites this paper as [30]

    Section 4 reports that SPP1+ macrophages expand in human heart tissue after myocardial infarction and are associated with fibrotic remodeling. The Conclusions describe their relevance across organs as suggesting a conserved fibrosis mechanism. Neither passage establishes that they are a conserved population across human inflammatory cardiomyopathies; the human cardiac example is post-infarction tissue. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • The coexistence of pro-inflammatory (Mac-rMHCII, Mono-C) and potentially reparative (Mac-ResL, Mac-TLF) macrophage subsets suggests that broad immunosuppression may unintentionally impair resolution processes.

    “The coexistence of pro-inflammatory (Mac-rMHCII, Mono-C) and potentially reparative (Mac-ResL, Mac-TLF) macrophage subsets suggests that broad immunosuppression may unintentionally impair resolution processes [9,10,30].”

    From Cardiac Macrophages Exhibit Dynamic Heterogeneity and Functional Specialization During Experimental Autoimmune Myocarditis. (2026) · cites this paper as [30]

    Section 4 describes macrophages with inflammatory and reparative functions and says that some subtypes express genes associated with both. It does not identify the four named subsets or say that broad immunosuppression may impair resolution; Section 8 instead discusses targeting distinct macrophage populations to mitigate fibrosis. The page numbers are unavailable in our copy. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Authors
Uhlig, M., Billig, S., Wienhold, J., & Schumacher, D.
Affiliations
RWTH Aachen University (DE)
Corresponding author
Uhlig, Moritz
Venue
Cells
Publisher
MDPI AG
Published
2025-02-27
Volume
14
Issue
5
Pages
345
ISSN
2073-4409 (ISSN-L)
OpenAlex
W4407992591
Cited by
29
References
58
Citations by year
2026: 22 · 2025: 7
FWCI
5.26
Type
journal article
Language
en
Open access
Locations
  • Cells (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • RWTH Publications (RWTH Aachen) (submittedVersion, other-oa)
  • RWTH Publications (RWTH Aachen)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
  • Health Sciences › Medicine › Genetics › Mesenchymal stem cell research
Keywords
myocardial fibrosis, SPP1+ macrophages, osteopontin, TREM2, macrophage heterogeneity, heart failure, extracellular matrix remodeling, myofibroblast activation, macrophage differentiation, platelet factor 4, GM-CSF, IL-17A, therapeutic target
MeSH terms
Animals, Fibrosis, Heart Diseases, Humans, Macrophages, Myocardium, Osteopontin

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