Delineating the role of TREM2 in chronic pancreatitis - PROJECT SUMMARY Chronic pancreatitis (CP) is a progressive digestive disorder characterized by persistent inflammation, irreversible fibrosis, and acinar cell damage. However, current treatment options remain limited, underscoring the need for effective, targeted therapeutic strategies through a deeper understanding of the disease microenvironment. Macrophages are pivotal players in the CP microenvironment, exhibiting dual roles in inflammation and tissue remodeling. A defining feature of macrophages is their remarkable phenotypic plasticity, enabling them to transition between pro-inflammatory and anti-inflammatory phenotypes. However, the specific macrophage phenotypes contributing to the immune imbalance in CP and their precise mechanisms of action remain poorly understood. TREM2 (Triggering Receptor Expressed on Myeloid cells 2), a transmembrane receptor of the immunoglobulin superfamily, has emerged as a critical modulator of tissue damage responses in multiple disease settings, though its function in CP remains unexplored. Our preliminary single-cell RNA-seq analyses of human CP tissues reveal an enrichment of inflammatory macrophages alongside a marked downregulation of TREM2 compared to non-diseased controls. This reduction in TREM2 correlates with marked increases in pro-inflammatory mediators, such as IL-1β and NF-κB, suggesting that TREM2 in macrophages contributes to maintaining homeostasis and restraining inflammatory signaling. Accordingly, diminished TREM2 expression appears to skew macrophages toward a pathologically hyper-inflammatory state. We hypothesize that loss of TREM2 disrupts the delicate balance among immune cells, fibroblasts, and acinar cells, fueling a self-reinforcing cycle of inflammation and fibrosis that exacerbates pancreatitis. To test this hypothesis, our R01 will leverage integrative single-cell transcriptomics, spatially resolved imaging, transgenic mouse models, functional organoid co-culture assays, and in vivo experiments to elucidate TREM2’s regulatory mechanisms in CP. This research aims to address two key scientific questions: (1) How does TREM2 suppress pro-inflammatory macrophage phenotypes and restrain IL-1β-induced inflammatory signaling? (2) How does the crosstalk among pro-inflammatory macrophages, fibroblasts, and acinar cells exacerbate the local inflammatory environment, leading to further pancreatic damage? Through this study, we aim to establish TREM2 as a pivotal inhibitory checkpoint in the NF-κB/NLRP3/IL-1β axis, preventing unchecked macrophage-driven inflammation, fibroblast activation, and further acinar cell damage. Successful completion of this project will deepen our mechanistic understanding of CP and identify new therapeutic strategies to mitigate fibrotic progression and preserve pancreatic function. Ultimately, these insights may guide the development of immunomodulatory treatments to attenuate CP severity, thereby transforming the clinical management of this devastating disorder.
