Abstract Background ACOD1 is the ubiquitous source of the anti-inflammatory metabolite itaconate. We hypothesised monocyte ACOD1 expression is an inhibitory pathway that limits intestinal inflammation. Methods We performed single-cell RNA sequencing of colonoscopic biopsies from >120 Crohn’s disease (CD) patients and healthy controls, with complementary analysis of DSS treated C57BL/6J (WT) mice, validated using flow cytometry in independent cohorts. Acod1–/– mice received 2% DSS in acute and recovery models, complemented by competitive bone marrow chimeric mice, anti-IFN / itaconate-derivate treatment and transgenic cell depletion models. Results We profile the monocyte / macrophage compartment in human IBD using single-cell RNA sequencing and identify a discrete population of intestinal CXCL9/10+ cells that accumulate in IBD, which we term inflammation associated monocytes (IAMs). These can be identified by the expression of CD319, CD274 and CCRL2, and demonstrate specific expression of IBD susceptibility genes, including NOD2. By performing cross-species analysis in mice, we show an analogous population of IAMs accumulate during chemically induced colitis. Using transgenic fate mapping approaches, we show these cells likely derive from a discrete MDP-precursor in the bone marrow and are locally imprinted to produce heightened IL-1β and TNF in mouse and humans. Importantly, we show that co-incident with a hyper-inflammatory phenotype, these same cells uniquely and specifically express aconitate decarboxylase (ACOD1) in response to local Toll-like receptor (TLR) and interferon (IFN) receptor signalling, to limit unrestricted cytokine production. Conclusion Thus, the intestinal environment after injury instructs both inflammation and recovery specifically within a transitioning population of monocytes that are absent in health. Reduced itaconate production from IAMs in CD may predispose to chronic inflammation and disease progression.
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