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Legumain Restrains Granuloma Formation by Inhibiting mTORC1/STAT1-Mediated M1 Macrophage Polarization in Sarcoidosis.

Advanced science (Weinheim, Baden-Wurttemberg, Germany)2026-04-05PubMed
Total: 85.5Innovation: 9Impact: 0Rigor: 0Citation: 0

Summary

Legumain is upregulated in sarcoid-like granulomas and restrains M1 polarization via integrin αvβ3-dependent inhibition of mTORC1/STAT1 signaling. Intratracheal lipid nanoparticles delivering Lgmn plasmid reduced granuloma burden in two mouse models, nominating LGMN supplementation as a therapeutic strategy.

Key Findings

  • LGMN expression is increased in macrophages within sarcoid-like granulomas.
  • Lgmn knockout exacerbates granulomatous inflammation with enhanced M1 polarization in P. acnes-induced mice.
  • LGMN binds integrin αvβ3 to inhibit mTORC1/STAT1 signaling, and intratracheal LNP-Lgmn therapy reduces granuloma formation.

Clinical Implications

LGMN-based therapies, including airway-delivered gene augmentation, could offer an alternative for refractory sarcoidosis; biomarkers of M1 polarization and mTORC1/STAT1 activity may guide patient selection.

Why It Matters

This study pinpoints a macrophage-intrinsic checkpoint of granuloma biology and demonstrates a tractable gene-delivery approach, bridging mechanistic insight with a translational therapeutic modality for sarcoidosis.

Limitations

  • Human sample validation and safety/pharmacokinetics of airway gene delivery were not addressed
  • Quantitative dosing-response and durability of LNP-mediated gene expression require further study

Future Directions

Advance LGMN augmentation to large-animal safety studies; explore small-molecule or peptide agonists; develop companion diagnostics of macrophage polarization to stratify sarcoidosis patients.

Study Information

Study Type
Basic/mechanistic study
Research Domain
Pathophysiology
Evidence Level
V - Preclinical mechanistic and therapeutic proof-of-concept in mouse models
Study Design
OTHER