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Published online before print June 24, 2004
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Department of Microbiology and Immunology, University of Louisville School of Medicine, Kentucky
1 Correspondence: Department of Microbiology and Immunology, Health Sciences Center, 319 Abraham Flexner Way, University of Louisville, Louisville, KY 40292. E-mail: bobstout{at}louisville.edu
| ABSTRACT |
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Key Words: inflammation cytokines regulation differentiation
| INTRODUCTION |
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(IFN-
) as the cytokine that enhanced macrophage cytotoxicity [8
] established the concept that the quality and intensity of macrophage activation depended on the nature of the signals generated by the activating agent [e.g., Toll-like receptor (TLR) or CD40 ligation] and the modulating cytokine [9
]. The development of the T helper cell type 1/2 (Th1/Th2) paradigm and the emphasis on the inflammatory and cytotoxic functions of macrophages maintained the perception that only Th1 cytokines such as IFN-
and tumor necrosis factor
(TNF-
) enhanced macrophage activation, whereas Th2 cytokines such as interleukin (IL)-4 and IL-10 inhibited macrophage activation [4
, 6
].
In 1992, Stein et al. [10
] published a clear demonstration that IL-4 could enhance the expression of macrophage mannose receptor. Subsequent studies established that IL-4 could up-regulate a distinctive set of genes, establishing a functional pattern quite different from that induced by IFN-
[7
]. The distinctive effect of IL-4 was underscored by coining the term "alternative activation," emphasizing the contrast with "classical activation" by IFN-
. The concept of alternatives to classical activation inspired a virtual avalanche of reports describing modifications of the functional pattern displayed by macrophages by treatment with IL-10, transforming growth factor-ß (TGF-ß), glucocorticoids, or ligation of Fc receptor for IgG (Fc
R) [7
, 11
12
13
]. These reports provided insight into the physiological basis of macrophage functional heterogeneity and the major role of microenvironmental influences on macrophage function. However, the emphasis of many of the reports was to categorize the responses into two generalized groups that corresponded to the Th1/Th2 dichotomy of type 1 proinflammatory/cytotoxic response (classical) and type 2 anti-inflammatory/humoral response (alternative) [7
, 11
12
13
]. The ability of IL-4 to enhance the production of inflammatory cytokines [14
] clearly erodes the concept of inflammatory versus suppressive macrophages being driven by Th1 versus Th2 cytokines, respectively. In the sections below, we present our perspective about the extent and origin of the phenotypic and functional heterogeneity within macrophage populations, the role of the tissue microenvironment in diffentially regulating macrophage function, and therapeutic targeting of macrophages in disease pathogenesis [4
, 5
, 15
].
| MACROPHAGES EXHIBIT AN ENORMOUS VARIETY OF FUNCTIONAL PATTERNS |
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The functional patterns described above represented static profiles of macrophages. In fact, the response of macrophages to a stimulus is not static. The study by Wells et al. [18
] described abundant differences between the genes expressed early (within the first 6 h) or late (1224 h or later) after LPS stimulation. Therefore, the functional pattern expressed by macrophages changes with time as the response progresses. It should be noted that the macrophages can be stimulated by early cytokines that they produce; so, with time, their functional pattern may shift in accordance with the cytokine milieu of their microenvironment [4
]. Macrophages treated overnight with IL-4 prior to stimulation with LPS, display enhanced production of TNF-
and IL-12, in stark contrast to the reduced production of these cytokines observed upon stimulation with LPS in the presence of IL-4 [14
]. We have corroborated this finding and expanded it to other cytokines, demonstrating that cytokines can synergize or antagonize in their impact on macrophages, depending on the sequence of treatment and time of activating stimulus.
Given the number of genes contributing to diversity of macrophage function, the synergistic and antagonistic effects of different cytokines and ligands on differential expression of those genes, and the number of cytokines, chemokines, hormones (including adrenergic and cholinergic agonists), TLR ligands, and other endogenous ligands (e.g., histamine, integrin ligands, peroxisome proliferator-activated receptor ligands, apoptotic cells) that modulate macrophage gene expression, it is our opinion that macrophages are capable of displaying a large number of distinct, functional patterns that have not yet been truly appreciated. An important concept to note is that the above studies clearly indicate that a macrophage will display a progression of functional changes (early and late gene expression) upon stimulation. Another important concept to consider is that identical macrophages placed in different modulating environments do not simply display different functional patterns but display different progressions of functional patterns in response to a common stimulus. From our perspective, this places restraints on our ability to establish that macrophages displaying different phenotypic or functional patterns are actually distinct lineages, as opposed to differentially regulated macrophages of common lineage. In the context of microenvironmental stimulation, the liver, burdened with clearing endotoxin and particulate material from the portal circulation [2 ], provides radically different environmental stimuli for macrophages compared with anti-inflammatory, privileged sites, such as the eye or the brain [3 , 19 ].
| FUNCTIONAL HETEROGENEITY OF MACROPHAGES IS A RESULT OF DIFFERENTIAL REGULATION BY THE MICROENVIRONMENT |
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or IL-4 initiates a signal cascade that results in differential modulation (enhancement or inhibition) of different genes at the transcriptional or post-transcriptional level (e.g., stabilization or destabilization of mRNA). It has been our experience that unless the signal cascade has initiated an apoptotic cascade, macrophages will eventually revert to their original, functional status after the cytokine signaling ceases. For example, in vivo or in vitro treatment of macrophages with cytokine alters their functional response pattern to LPS. However, if the macrophages are washed after cytokine treatment and held in the absence of cytokine for 12 days before LPS stimulation, the functional response pattern is essentially identical to that of macrophages that had not been treated with cytokine. A similar reversion to basal macrophage phenotype is observed when human monocyte-derived, immature dendritic cells (DC) are removed from IL-4 + granulocyte macrophage-colony stimulating factor (GM-CSF) and placed in a neutral environment [20
]. We have been able to corroborate this observation with immature DC (CD11c+) derived by IL-4 + GM-CSF treatment of murine BM-derived and peritoneal macrophages (unpublished data). The point is that the majority of type 1 and type 2 cytokines does not seem to induce differentiation of macrophages into stable subsets but rather induces regulatory cascades that transiently alter the functional pattern of response of macrophages.
Macrophages from the lung (interstitial and alveolar), peritoneum, liver (Kupffer cells), and brain (microglia) are usually considered to be separate lineages of macrophages with distinct and unique functions [2
, 3
]. Originally, these populations (peritoneal macrophages being the exception) were thought to be maintained during adult life by precursors that seeded the organs during development. Current evidence indicates that the slow turnover of these long-lived populations is maintained, at least in part, by immigration of blood monocytes [2
, 3
]. Establishment of these populations as distinct, differentiation lineages is based on the distinct pattern of functional responsiveness and pattern of surface molecules expressed [2
, 3
]. There does not appear to be a single membrane molecule that by itself could phenotypically distinguish these tissue macrophage populations. A comparative summary of the functional and phenotypic characteristics of these populations, adapted from Guillemin and Brew [3
], Hanisch [21
], and Laskin et al. [2
], is presented in Table 1
. The majority of differences is quantitative differences in level of expression of a molecule. Thus, each population displays a unique functional and phenotypic pattern. However, the macrophages within each of these populations do not uniformly display the same functional and phenotypic pattern. Significant heterogeneity exists within the macrophage population of each tissue. For example, the functional phenotype of Kupffer cells depends on their proximity to the portal vein [2
]. Density gradient fractionation of lung interstitial and alveolar macrophage populations yields subpopulations differing in phenotype (e.g., degree of expression of Fc
R and class II MHC) and phagocytic function [2
]. Each population is fully capable of changing its functional pattern, as evidenced by the response to infectious or inflammatory insult [2
, 3
, 22
]. The most dramatic are the microglia that display a ramified morphology and support neuronal survival by producing cytokines such as brain-derived neurotrophic factor and TGF-ß [21
, 23
]. In vitro or during inflammatory responses in the brain, microglia lose their characteristic morphology, become migratory, and produce abundant oxidative radicals and inflammatory cytokines [3
, 22
]. How many of the distinctions between the various tissue macrophage populations are a result of reversible adaptation to the microenvironment of the tissue? If these macrophage populations are placed in identical microenvironments for several days, how many of the functional and phenotypic differences will be retained? As stated in the previous section, each of these tissues provides different environmental stimuli for macrophages. As stable acquisition of a trait is the hallmark of differentiation, we currently are pursuing this line of experimentation in an attempt to determine which of the functional traits of these tissue macrophages are a result of reversible adaptation to the host tissues microenvironment and which are a result of differentiation.
|
B ligand) is a potent inducer of osteoclastogenesis [24
] and apparently, also the interesting synergistic pairing of TNF-
and TGF-ß [25
]. The key genes that are expressed uniquely in osteoclasts are for the TRAP, calcitonin receptor, and cathepsin K [24
]. The end-stage cell is clearly differentiated in that it is the polykaryon product of cell fusion that has developed clear cell-body polarity. However, macrophages can be readily driven to express the osteoclast genes and display bone-resorbing activity (Fig. 1)
[25
]. Can prefusion, single-cell osteoclasts removed from bone revert to a macrophage functional phenotype given the appropriate environment? The role of prefusion osteoclasts versus macrophages with bone-resorption activity in atherogenic plaque decalcification is addressed below. | DIFFERENTIAL REGULATION OF MACROPHAGES DURING INFLAMMATORY DISEASE |
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| CONCLUDING REMARKS |
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| ACKNOWLEDGEMENTS |
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Received May 5, 2004; accepted June 1, 2004.
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