Distinct macrophage lineages contribute to disparate patterns of cardiac recovery and remodeling in the neonatal and adult heart

KJ Lavine, S Epelman, K Uchida, KJ Weber… - Proceedings of the …, 2014 - pnas.org
KJ Lavine, S Epelman, K Uchida, KJ Weber, CG Nichols, JD Schilling, DM Ornitz
Proceedings of the National Academy of Sciences, 2014pnas.org
The mechanistic basis for why inflammation is simultaneously both deleterious and essential
for tissue repair is not fully understood. Recently, a new paradigm has emerged: Organs are
replete with resident macrophages of embryonic origin distinct from monocyte-derived
macrophages. This added complexity raises the question of whether distinct immune cells
drive inflammatory and reparative activities after injury. Previous work has demonstrated that
the neonatal heart has a remarkable capacity for tissue repair compared with the adult heart …
The mechanistic basis for why inflammation is simultaneously both deleterious and essential for tissue repair is not fully understood. Recently, a new paradigm has emerged: Organs are replete with resident macrophages of embryonic origin distinct from monocyte-derived macrophages. This added complexity raises the question of whether distinct immune cells drive inflammatory and reparative activities after injury. Previous work has demonstrated that the neonatal heart has a remarkable capacity for tissue repair compared with the adult heart, offering an ideal context to examine these concepts. We hypothesized that unrecognized differences in macrophage composition is a key determinant of cardiac tissue repair. Using a genetic model of cardiomyocyte ablation, we demonstrated that neonatal mice expand a population of embryonic-derived resident cardiac macrophages, which generate minimal inflammation and promote cardiac recovery through cardiomyocyte proliferation and angiogenesis. During homeostasis, the adult heart contains embryonic-derived macrophages with similar properties. However, after injury, these cells were replaced by monocyte-derived macrophages that are proinflammatory and lacked reparative activities. Inhibition of monocyte recruitment to the adult heart preserved embryonic-derived macrophage subsets, reduced inflammation, and enhanced tissue repair. These findings indicate that embryonic-derived macrophages are key mediators of cardiac recovery and suggest that therapeutics targeting distinct macrophage lineages may serve as novel treatments for heart failure.
pnas.org