In response to microenvironmental signals, macrophages undergo different activation, including the "classic" proinflammatory phenotype (also called M1), the "alternative" activation induced by the IL-4/IL-13 trigger, and the related but distinct heterogeneous M2 polarization associated with the anti-inflammatory profile. The latter is induced by several stimuli, including IL-10 and TGF-. Macrophagepolarized activation has profound effects on immune and inflammatory responses and in tumor biology, but information on the underlying molecular pathways is scarce. In the present study, we report that alternative polarization of macrophages requires the transcription factor c-MYC. In macrophages, IL-4 and different stimuli sustaining M2-like polarization induce c-MYC expression and its translocation to the nucleus. c-MYC controls the induction of a subset (45%) of genes associated with alternative activation. ChIP assays indicate that c-MYC directly regulates some genes associated with alternative activation, including SCARB1, ALOX15, and MRC1, whereas others, including CD209, are indirectly regulated by c-MYC. c-MYC up-regulates the IL-4 signaling mediators signal transducer and activator of transcription-6 and peroxisome proliferator-activated receptor␥, is also expressed in tumorassociated macrophages, and its inhibition blocks the expression of protumoral genes including VEGF, MMP9, HIF-1␣, and TGF-. We conclude that c-MYC is a key player in alternative macrophage activation, and is therefore a potential therapeutic target in pathologies related to these cells, including tumors. (Blood. 2012;119(2):411-421)
IntroductionMacrophages are specialized phagocytic cells involved in multiple processes, both in homeostatic conditions and during the immune response after tissue damage or exposure to a pathogen. Macrophages are characterized by a striking heterogeneity, which can be partially ascribed to their origin by self-renewal of resident postmitotic cells and by monocyte subsets recruited and differentiated locally. 1-3 A second element shaping macrophage heterogeneity is the microenvironment, both under homeostatic conditions, with the hosting tissue profoundly influencing macrophage differentiation, and in the context of an inflammatory or immune response, which generates a wide range of polarized activation states. [3][4][5][6] Activation with IFN-␥, alone or in combination with pathogen-derived signals such as lipopolysaccharide (LPS), leads to classically activated macrophages, also referred to as M1 cells, which develop proinflammatory type 1 immune responses. Macrophage exposure to other immune signals results in profoundly different functional phenotypes. These include "alternatively activated" macrophages caused by IL-4/IL-13 stimulation, which are associated with type 2 immune responses and a spectrum of functional phenotypes related to anti-inflammatory, angiogenic, and tissue-repair properties induced in macrophages by stimuli including TGF-, immune complexes, glucocorticoids, and IL-10. 3,4,6,7 Further...