Misharin et al. elucidate the fate and function of monocyte-derived alveolar macrophages during the course of pulmonary fibrosis. These cells persisted throughout the life span, were enriched for the expression of profibrotic genes, and their genetic ablation ameliorated development of pulmonary fibrosis.

Complex higher-order RNA structures play critical roles in all facets of gene expression; however, the through-space interaction networks that define tertiary structures and govern sampling of multiple conformations are poorly understood. Here we describe single-molecule RNA structure analysis in which multiple sites of chemical modification are identified in single RNA strands by massively parallel sequencing and then analyzed for correlated and clustered interactions. The strategy thus identifies RNA interaction groups by mutational profiling (RING-MaP) and makes possible two expansive applications. First, we identify throughspace interactions, create 3D models for RNAs spanning 80-265 nucleotides, and characterize broad classes of intramolecular interactions that stabilize RNA. Second, we distinguish distinct conformations in solution ensembles and reveal previously undetected hidden states and large-scale structural reconfigurations that occur in unfolded RNAs relative to native states. RING-MaP single-molecule nucleic acid structure interrogation enables concise and facile analysis of the global architectures and multiple conformations that govern function in RNA. These functions are mediated by tiered levels of information: The simplest is the primary sequence, and the most complex is the higher-order structure that governs interactions with ligands, proteins, and other RNAs (1, 2). Many RNAs can form more than one stable structure, and these distinct conformations often have different biological activities (3, 4). Currently, the rate of describing new RNA sequences vastly exceeds abilities to examine their structures.Here we characterize through-space interactions and multiple conformations in single RNAs by melding chemical probing and massively parallel sequencing. Because massively parallel sequencing reports the sequences of single templates, each read is fundamentally a single-molecule observation (5). We first modified RNA with a reagent that is sensitive to the underlying RNA structure and then detected multiple adducts in individual RNA strands (Fig. 1). Chemical adducts were detected as sequence mutations based on their ability to induce efficient misreading of the template nucleotide by a reverse transcriptase enzyme, an approach called mutational profiling, or MaP (6). Singlemolecule probing data were used in two distinct ways: to detect correlated RNA modifications reflecting higher-order through-space interactions (Fig. 1A) and to examine multiple conformations in single in-solution ensembles (Fig. 1B). Results and DiscussionMultisite Dimethyl Sulfate Reactivity with RNA. We used dimethyl sulfate (DMS) to probe the structures of three RNAs: the Escherichia coli thiamine pyrophosphate (TPP) riboswitch (79 nt) (7), the Tetrahymena group I intron P546 domain (160 nt) (8), and the Bacillus stearothermophilus RNase P catalytic domain (265 nt) (9). RNAs were selected to illustrate distinct RNA folding features and to emphasize increasingly difficult analysis challenges. The TPP riboswitch binds the...

CAR T-cell toxicities resembling hemophagocytic lymphohistiocytosis (HLH) occur in a subset of patients with cytokine release syndrome (CRS). As a variant of conventional CRS, a comprehensive characterization of CAR T-cell associated HLH (carHLH) and investigations into associated risk factors are lacking. In the context of 59 patients infused with CD22 CAR T-cells where a substantial proportion developed carHLH, we comprehensively describe the manifestations and timing of carHLH as a CRS variant and explore factors associated with this clinical profile. Amongst 52 subjects with CRS, 21 (40.4%) developed carHLH. Clinical features of carHLH included hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia, coagulopathy, hepatic transaminitis, hyperbilirubinemia, severe neutropenia, elevated lactate dehydrogenase and occasionally hemophagocytosis. Development of carHLH was associated with pre-infusion NK-cell lymphopenia and higher bone marrow T/NK-cell ratio, which was further amplified with CAR T-cell expansion. Following CRS, more robust CAR T-cell and CD8 T-cell expansion in concert with pronounced NK-cell lymphopenia amplified pre-infusion differences in those with carHLH without evidence for defects in NK-cell mediated cytotoxicity. CarHLH was further characterized by persistent elevation of HLH-associated inflammatory cytokines, which contrasted with declining levels in those without carHLH. In the setting of CAR T-cell mediated expansion, clinical manifestations and immunophenotypic profiling in those with carHLH overlap with features of secondary HLH, prompting consideration of an alternative framework for identification and management of this toxicity profile to optimize outcomes following CAR T-cell infusion.

Summary Thiamine pyrophosphate (TPP) riboswitches regulate essential genes in bacteria by changing conformation upon binding intracellular TPP. Previous studies using fragment-based approaches identified small molecule “fragments” that bind this gene-regulatory mRNA domain. Crystallographic studies now show that, despite having micromolar Kds, four different fragments bind the TPP riboswitch site-specifically, occupying the pocket that recognizes the aminopyrimidine of TPP. Unexpectedly, the unoccupied site that would recognize the pyrophosphate of TPP rearranges into a structure distinct from that of the cognate complex. This idiosyncratic fragment-induced conformation, also characterized by small-angle X-ray scattering (SAXS) and chemical probing (SHAPE), represents a possible mechanism for adventitious ligand discrimination by the riboswitch, and suggests that off-pathway conformations of RNAs can be targeted for drug development. Our structures, together with previous screening studies, demonstrate the feasibility of fragment-based drug discovery against RNA targets.