{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T03:31:30Z","timestamp":1793244690079,"version":"4.5.0"},"reference-count":69,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["iMeta"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Severe\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    pneumonia is associated with substantial mortality and is characterized by intense systemic inflammation that coexists with a failure to control infection. The cellular changes underlying the transition from effective host defense to immune dysfunction remain incompletely defined. Here, we constructed a severity\u2010focused single\u2010cell transcriptomic atlas of 708,894 peripheral blood mononuclear cells from 100 individuals (54 healthy controls, 23 patients with mild disease, and 23 patients with severe disease), complemented by plasma protein measurements and flow cytometry. Mild disease was characterized by a relatively coordinated peripheral immune response, with preserved monocyte regulatory and tissue\u2010repair programs, preserved cytotoxic lymphocyte activity, and coordinated interactions between T follicular helper cells and B cells. Severe disease showed marked monocyte inflammation together with widespread disruption of adaptive immune responses. Classical monocytes expanded and showed increased expression of\n                    <jats:italic>S100A8\/A9\/A12<\/jats:italic>\n                    , accompanied by enhanced\n                    <jats:italic>TLR4\u2013MYD88<\/jats:italic>\n                    signaling and elevated plasma S100 proteins. These changes were accompanied by impaired dendritic cell antigen presentation, expansion of immunoregulatory monocyte states resembling monocytic myeloid\u2010derived suppressor cells, cytotoxicity\u2010 and exhaustion\u2010associated changes in CD8\n                    <jats:sup>+<\/jats:sup>\n                    T cells and natural killer cells, hyperactivated yet poorly coordinated CD4\n                    <jats:sup>+<\/jats:sup>\n                    T cell states, and weaker B cell receptor signaling despite plasma cell expansion. These findings delineate a severity\u2010associated peripheral immune state characterized by monocyte\u2010centered inflammatory signatures and features of altered adaptive immune coordination, and provide a basis for future mechanistic investigation of monocyte\u2010derived\n                    <jats:italic>S100<\/jats:italic>\n                    alarmins and severity\u2010associated myeloid remodeling.\n                  <\/jats:p>","DOI":"10.1002\/imt2.70172","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:18:16Z","timestamp":1790050696000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Monocyte inflammation and adaptive immune dysfunction in severe\n                    <i>Klebsiella pneumoniae<\/i>\n                    pneumonia"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-9508","authenticated-orcid":false,"given":"Hongquan","family":"Chen","sequence":"first","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention Chinese Center for Disease Control and Prevention &amp; Chinese Academy of Preventive Medicine Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shanxi Hospital of Traditional Chinese Medicine Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Liu","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Pneumoconiosis, MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Key Laboratory of Chronic Respiratory Diseases and Pneumoconiosis The First Hospital of Shanxi Medical University Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Dong","sequence":"additional","affiliation":[{"name":"Research Center for Reverse Microbial Etiology, Workstation of Academician Shanxi Medical University Taiyuan People's Republic of China"},{"name":"Ophthalmic Microbiology Laboratory, Shanxi Eye Hospital Shanxi Medical University Taiyuan Shanxi People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanying","family":"Feng","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention Chinese Center for Disease Control and Prevention &amp; Chinese Academy of Preventive Medicine Beijing China"},{"name":"Department of Internal Medicine, The First Clinical Medical College Shanxi Medical 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Pneumoconiosis, MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Key Laboratory of Chronic Respiratory Diseases and Pneumoconiosis The First Hospital of Shanxi Medical University Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shanxi Hospital of Traditional Chinese Medicine Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiming","family":"Kang","sequence":"additional","affiliation":[{"name":"Research Center for Reverse Microbial Etiology, Workstation of Academician Shanxi Medical University Taiyuan People's Republic of China"},{"name":"Ophthalmic Microbiology Laboratory, Shanxi Eye Hospital Shanxi Medical University Taiyuan Shanxi People's Republic of 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