红细胞清除作用调节巨噬细胞向脑出血后恢复。

Erythrocyte efferocytosis modulates macrophages towards recovery after intracerebral hemorrhage.

机构信息

Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA.

Department of Biological Engineering, Koch Institute for Integrative Cancer Research at Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.

出版信息

J Clin Invest. 2018 Feb 1;128(2):607-624. doi: 10.1172/JCI95612. Epub 2017 Dec 18.

Abstract

Macrophages are a source of both proinflammatory and restorative functions in damaged tissue through complex dynamic phenotypic changes. Here, we sought to determine whether monocyte-derived macrophages (MDMs) contribute to recovery after acute sterile brain injury. By profiling the transcriptional dynamics of MDMs in the murine brain after experimental intracerebral hemorrhage (ICH), we found robust phenotypic changes in the infiltrating MDMs over time and demonstrated that MDMs are essential for optimal hematoma clearance and neurological recovery. Next, we identified the mechanism by which the engulfment of erythrocytes with exposed phosphatidylserine directly modulated the phenotype of both murine and human MDMs. In mice, loss of receptor tyrosine kinases AXL and MERTK reduced efferocytosis of eryptotic erythrocytes and hematoma clearance, worsened neurological recovery, exacerbated iron deposition, and decreased alternative activation of macrophages after ICH. Patients with higher circulating soluble AXL had poor 1-year outcomes after ICH onset, suggesting that therapeutically augmenting efferocytosis may improve functional outcomes by both reducing tissue injury and promoting the development of reparative macrophage responses. Thus, our results identify the efferocytosis of eryptotic erythrocytes through AXL/MERTK as a critical mechanism modulating macrophage phenotype and contributing to recovery from ICH.

摘要

巨噬细胞通过复杂的动态表型变化,既是受损组织中促炎和修复功能的来源。在这里,我们试图确定单核细胞来源的巨噬细胞(MDM)是否有助于急性无菌性脑损伤后的恢复。通过对实验性脑出血(ICH)后鼠脑中 MDM 的转录动态进行分析,我们发现浸润的 MDM 随时间推移发生了明显的表型变化,并证明 MDM 对于最佳血肿清除和神经功能恢复至关重要。接下来,我们确定了吞噬具有暴露的磷脂酰丝氨酸的红细胞直接调节鼠源和人源 MDM 表型的机制。在小鼠中,受体酪氨酸激酶 AXL 和 MERTK 的缺失减少了红细胞凋亡的吞噬作用和血肿清除,导致神经功能恢复恶化、铁沉积增加,并在 ICH 后减少了巨噬细胞的替代激活。ICH 发病后,循环中可溶性 AXL 水平较高的患者 1 年预后较差,这表明通过增强吞噬作用来治疗可能通过减少组织损伤和促进修复性巨噬细胞反应的发展来改善功能预后。因此,我们的结果确定了通过 AXL/MERTK 吞噬凋亡红细胞是调节巨噬细胞表型并有助于从 ICH 中恢复的关键机制。

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