{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T05:06:35Z","timestamp":1779771995659,"version":"3.53.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008238","name":"Hebei Provincial Department of Science and Technology","doi-asserted-by":"publisher","award":["22377705D"],"award-info":[{"award-number":["22377705D"]}],"id":[{"id":"10.13039\/501100008238","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is characterized by intense systemic inflammation and immune dysregulation, with monocytes playing a central role in its progression. Patients with HBV-ACLF typically receive comprehensive treatment including artificial liver support system (ALSS). Here, we report a case of HBV-ACLF in which single-cell RNA sequencing (scRNA-seq) showing dynamic reprogramming of monocyte upon ALSS treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted the single-cell and bulk RNA sequencing with peripheral blood mononuclear cells (PBMCs) from a patient with type B HBV-ACLF, both before and after ALSS therapy. The scRNA-seq data were subjected to bioinformatic analyses, including graph-based clustering, pseudotime trajectory inference, and M1\/M2 polarization scoring. Findings were further validated using matched bulk transcriptomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among PBMCs, monocytes displayed the most dramatic transcriptomic changes. A distinct inflammatory monocyte subpopulation (Mono4) was identified, featuring upregulated mitochondrial genes, and enrichment of secreted factors associated with platelet activation and systemic inflammation. During the ALSS-based comprehensive treatment course, we observed a decreased proportion of Mono4 and attenuation of its pro-inflammatory secretory signature. Pseudotime analysis further revealed a differentiation trajectory from classical monocytes (Mono1 and Mono2) to Mono4, which decreased with treatment. Consistent with these findings, bulk RNA-seq deconvolution confirmed the monocyte-centric immune landscape.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this case report, comprehensive treatment including ALSS was linked to monocyte reprogramming and the decreased pro-inflammatory Mono4 subpopulation. Furthermore, Mono4 may play a central role in the systemic hyperinflammatory response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1801893","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:50:58Z","timestamp":1779771058000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: dynamic monocyte reprogramming during ALSS therapy in type B HBV-ACLF revealed by single-cell transcriptomics"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiale","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Hebei Clinical Research Center for Digestive Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahua","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Hebei Clinical Research Center for Digestive Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feiyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Beijing Changping Hospital of Traditional Chinese Medicine, The Affiliated Changping Hospital of Beijing University of Chinese Medicine","place":["Beijing, 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Hebei Clinical Research Center for Digestive Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zian","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Hebei Clinical Research Center for Digestive Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Hebei Clinical Research Center for Digestive Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoshuang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Hebei Clinical Research Center for Digestive Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Hebei Clinical Research Center for Digestive Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guifen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Hebei Clinical Research Center for Digestive Diseases","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Wang","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Hebei University of Engineering","place":["Handan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yansheng","family":"Jia","sequence":"additional","affiliation":[{"name":"The Fifth Hospital of Shijiazhuang City","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, 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