# Identification of key macrophage-related genes in systemic sclerosis–associated interstitial lung disease based on single-cell and bulk transcriptomic data

**Authors:** Ting Zhao, Yulin Wang, Fu-an Lin, Eric Shelden, Eric Shelden, Eric Shelden

PMC · DOI: 10.1371/journal.pone.0344166 · 2026-03-05

## TL;DR

This study identifies key macrophage-related genes in a deadly lung disease linked to systemic sclerosis, offering potential new therapeutic targets.

## Contribution

Novel integration of single-cell and bulk transcriptomic data to identify macrophage-related genes in SSc-ILD.

## Key findings

- ARG2, ELF3, and NKX2–1 are key macrophage-related genes in SSc-ILD.
- Lysosomal pathway is co-enriched with these key genes.
- ARG2 and ELF3 show drug binding energies below −5 kcal/mol with cyclophosphamide.

## Abstract

Systemic sclerosis–associated interstitial lung disease (SSc-ILD) is a major clinical challenge with no effective treatments. It is also the leading cause of death in patients with systemic sclerosis. Thus, understanding its underlying molecular mechanisms, particularly those related to macrophage-related gene functions, is critical to address this urgent medical need.

In this study, single-cell and transcriptomic data retrieved from a public database were analyzed to investigate the underlying molecular mechanisms of SSc-ILD. A series of comprehensive analyses was conducted, including cell–cell communication analysis, pseudotime trajectory analysis, and high-dimensional weighted gene co-expression network analysis, to identify pertinent genes linked to macrophage modules. Candidate genes were determined by intersecting differentially expressed genes (DEGs) with macrophage module genes. Subsequently, key genes were identified through protein–protein interaction (PPI) network analysis and gene expression validation. Various analytical procedures were used to evaluate the function of the key genes in the regulatory roles of SSc-ILD, including enrichment analysis, immune infiltration analysis, drug prediction, and molecular docking.

Of the 1515 DEGs and 400 macrophage module genes intersected, 50 candidate genes were identified. In particular, ARG2, ELF3, and NKX2–1 emerged as key genes through subsequent PPI network analyses and gene expression evaluations. Enrichment analyses revealed a notable co-enrichment of the lysosomal pathway with these key genes. Moreover, immune infiltration analysis revealed a strong negative correlation between NKX2–1 and monocytes, whereas ELF3 and ARG2 exhibited a positive association with activated dendritic cells. The molecular docking results showed that the binding energies of ARG2-SKA-111/cyclophosphamide and ELF3–voruciclib/cyclophosphamide were less than − 5 kcal/mol.

The findings of this study highlight the key roles of ARG2, ELF3, and NKX2−1 in macrophage-related mechanisms of SSc-ILD, providing insights into potential therapeutic targets. Further research is necessary to explore their functional implications in disease progression and treatment.

## Linked entities

- **Genes:** ARG2 (arginase 2) [NCBI Gene 384], ELF3 (E74 like ETS transcription factor 3) [NCBI Gene 1999], NKX2-1 (NK2 homeobox 1) [NCBI Gene 7080]
- **Chemicals:** cyclophosphamide (PubChem CID 2907), SKA-111 (PubChem CID 82549899), voruciclib (PubChem CID 67409219)
- **Diseases:** systemic sclerosis (MONDO:0005100)

## Full-text entities

- **Genes:** LYVE1 (lymphatic vessel endothelial hyaluronan receptor 1) [NCBI Gene 10894] {aka CRSBP-1, HAR, LYVE-1, XLKD1}, SCGB1A1 (secretoglobin family 1A member 1) [NCBI Gene 7356] {aka CC10, CC16, CCPBP, CCSP, UGB, UP-1}, IL13 (interleukin 13) [NCBI Gene 3596] {aka IL-13, P600}, MUC1 (mucin 1, cell surface associated) [NCBI Gene 4582] {aka ADMCKD, ADMCKD1, ADTKD2, CA 15-3, CD227, Ca15-3}, GPNMB (glycoprotein nmb) [NCBI Gene 10457] {aka HGFIN, NMB, PLCA3}, ARG1 (arginase 1) [NCBI Gene 383], HSD17B6 (hydroxysteroid 17-beta dehydrogenase 6) [NCBI Gene 8630] {aka HSE, RODH, SDR9C6}, KCNN4 (potassium calcium-activated channel subfamily N member 4) [NCBI Gene 3783] {aka DHS2, IK, IK1, IKCA1, KCA4, KCa3.1}, IGKC (immunoglobulin kappa constant) [NCBI Gene 3514] {aka HCAK1, IGKCD, Km}, ARG2 (arginase 2) [NCBI Gene 384], LGALS9 (galectin 9) [NCBI Gene 3965] {aka HUAT, LGALS9A}, DOCK2 (dedicator of cytokinesis 2) [NCBI Gene 1794] {aka IMD40}, ICAM1 (intercellular adhesion molecule 1) [NCBI Gene 3383] {aka BB2, CD54, P3.58}, ELF3 (E74 like ETS transcription factor 3) [NCBI Gene 1999] {aka EPR-1, ERT, ESE-1, ESX}, Arg2 (arginase type II) [NCBI Gene 11847] {aka AII}, PSAP (prosaposin) [NCBI Gene 5660] {aka GLBA, PARK24, PSAPD, SAP1, SAP2}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, TREM2 (triggering receptor expressed on myeloid cells 2) [NCBI Gene 54209] {aka AD17, PLOSL2, TREM-2, Trem2a, Trem2b, Trem2c}, HOXB3 (homeobox B3) [NCBI Gene 3213] {aka HOX2, HOX2G, Hox-2.7}, S100A9 (S100 calcium binding protein A9) [NCBI Gene 6280] {aka 60B8AG, CAGB, CFAG, CGLB, L1AG, LIAG}, CDH1 (cadherin 1) [NCBI Gene 999] {aka Arc-1, BCDS1, CD324, CDHE, ECAD, LCAM}, CEBPB (CCAAT enhancer binding protein beta) [NCBI Gene 1051] {aka C/EBP-beta, IL6DBP, NF-IL6, TCF5}, POLR2A (RNA polymerase II subunit A) [NCBI Gene 5430] {aka NEDHIB, POLR2, POLRA, RPB1, RPBh1, RPO2}, NOS2 (nitric oxide synthase 2) [NCBI Gene 4843] {aka HEP-NOS, INOS, NOS, NOS2A}, IFNA1 (interferon alpha 1) [NCBI Gene 3439] {aka IFL, IFN, IFN-ALPHA, IFN-alphaD, IFNA13, IFNA@}, IGHM (immunoglobulin heavy constant mu) [NCBI Gene 3507] {aka AGM1, MU, VH}, NKX2-1 (NK2 homeobox 1) [NCBI Gene 7080] {aka BCH, BHC, NK-2, NKX2.1, NKX2A, NMTC1}, SDC1 (syndecan 1) [NCBI Gene 6382] {aka CD138, SDC, SYND1, syndecan}, FABP5 (fatty acid binding protein 5) [NCBI Gene 2171] {aka E-FABP, EFABP, KFABP, PA-FABP, PAFABP}, MERTK (MER proto-oncogene, tyrosine kinase) [NCBI Gene 10461] {aka MER, RP38, Tyro12, c-Eyk, c-mer}, MYC (MYC proto-oncogene, bHLH transcription factor) [NCBI Gene 4609] {aka MRTL, MYCC, bHLHe39, c-Myc}, CCR2 (C-C motif chemokine receptor 2) [NCBI Gene 729230] {aka CC-CKR-2, CCR-2, CCR2A, CCR2B, CD192, CKR2}, MMP9 (matrix metallopeptidase 9) [NCBI Gene 4318] {aka CLG4B, GELB, MANDP2, MMP-9}, DYM (dymeclin) [NCBI Gene 54808] {aka DMC, SMC}, FCN1 (ficolin 1) [NCBI Gene 2219] {aka FCNM}, S100A14 (S100 calcium binding protein A14) [NCBI Gene 57402] {aka BCMP84, S100A15}, CD44 (CD44 molecule (IN blood group)) [NCBI Gene 960] {aka CDW44, CSPG8, ECM-III, ECMR-III, H-CAM, HCELL}, SMC1A (structural maintenance of chromosomes 1A) [NCBI Gene 8243] {aka CDLS2, DEE85, DXS423E, EIEE85, SB1.8, SMC1}, CD86 (CD86 molecule) [NCBI Gene 942] {aka B7-2, B7.2, B70, BU63, CD28LG2, CD86 v6}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, RAB25 (RAB25, member RAS oncogene family) [NCBI Gene 57111] {aka CATX-8, RAB11C}, CD9 (CD9 molecule) [NCBI Gene 928] {aka BTCC-1, DRAP-27, MIC3, MRP-1, TSPAN-29, TSPAN29}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, S100A8 (S100 calcium binding protein A8) [NCBI Gene 6279] {aka 60B8AG, CAGA, CFAG, CGLA, CP-10, L1Ag}, CD63 (CD63 molecule) [NCBI Gene 967] {aka AD1, HOP-26, ME491, MLA1, OMA81H, Pltgp40}, F3 (coagulation factor III, tissue factor) [NCBI Gene 2152] {aka CD142, TF, TFA}, FABP4 (fatty acid binding protein 4) [NCBI Gene 2167] {aka A-FABP, AFABP, ALBP, HEL-S-104, aP2}, CAPG (capping actin protein, gelsolin like) [NCBI Gene 822] {aka AFCP, HEL-S-66, MCP}, MRC1 (mannose receptor C-type 1) [NCBI Gene 4360] {aka CD206, CLEC13D, CLEC13DL, MMR, MRC1L1, bA541I19.1}, HLA-C (major histocompatibility complex, class I, C) [NCBI Gene 3107] {aka D6S204, HLA-JY3, HLAC, HLC-C, MHC, PSORS1}, SCD (stearoyl-CoA desaturase) [NCBI Gene 6319] {aka FADS5, MSTP008, SCD1, SCDOS, hSCD1}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, RAD21 (RAD21 cohesin complex component) [NCBI Gene 5885] {aka CDLS4, HR21, HRAD21, MCD1, MGS, NXP1}, AGR2 (anterior gradient 2, protein disulphide isomerase family member) [NCBI Gene 10551] {aka AG-2, AG2, GOB-4, HAG-2, HEL-S-116, HPC8}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, KRT19 (keratin 19) [NCBI Gene 3880] {aka CK19, K19, K1CS}, CSN3 (casein kappa) [NCBI Gene 1448] {aka CNS10, CSN10, CSNK, KCA}, INHBE (inhibin subunit beta E) [NCBI Gene 83729], COL1A1 (collagen type I alpha 1 chain) [NCBI Gene 1277] {aka CAFYD, EDSARTH1, EDSC, OI1, OI2, OI3}, CD163 (CD163 molecule) [NCBI Gene 9332] {aka M130, MM130, SCARI1}
- **Diseases:** pulmonary alveolar proteinosis (MESH:D011649), gastric cancer (MESH:D013274), autoimmune disease (MESH:D001327), PS synthesis (MESH:C566882), lung adenocarcinoma (MESH:D000077192), ILD (MESH:D017563), type I diabetes mellitus (MESH:D003922), pulmonary fibrosis (MESH:D011658), tuberculosis (MESH:D014376), carcinogenesis (MESH:D063646), dysfunction (MESH:D006331), interstitial lung inflammation (MESH:D011014), respiratory distress syndrome (MESH:D012128), germ cell carcinoma (MESH:D009373), SSc (MESH:D012595), alveolar (MESH:D002282), respiratory tract infections (MESH:D012141), Inflammation (MESH:D007249), fibrosis (MESH:D005355), alveolar epithelial cell injury (MESH:D009375), influenza A (MESH:D007251), death (MESH:D003643), EB virus infection (MESH:D014777), pulmonary arterial hypertension (MESH:D000081029), IPF (MESH:D054990), and cardiovascular diseases (MESH:D002318), infection (MESH:D007239), vascular lesions (MESH:D014652), cerebral ischemia (MESH:D002545), lung diseases (MESH:D008171), tumor (MESH:D009369), deterioration of lung function (MESH:D055371), vascular injury (MESH:D057772), cerebrovascular disease (MESH:D002561), graft-versus-host disease (MESH:D006086)
- **Chemicals:** Voruciclib (MESH:C000627065), glutamine (MESH:D005973), lipopolysaccharide (MESH:D008070), lipid (MESH:D008055), hydrogen (MESH:D006859), Cyclophosphamide (MESH:D003520), ROS (MESH:D017382), Pyruvate (MESH:D019289), 5-methylnaphtho[1,2-d]thiazol-2-amine (-), monosaccharide (MESH:D009005), TCA (MESH:D014233), carbohydrate (MESH:D002241), arginine (MESH:D001120)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]

## Figures

11 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12962529/full.md

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Source: https://tomesphere.com/paper/PMC12962529