IntroductionTumor-associated macrophages (TAMs) infiltrate tumors, which often predicts a poor survival prognosis. TAMs apparently support tumor development by improving vascularization and cell survival rather than behaving tumoricidally (for review, see Lewis and Pollard 1 ).Features characterizing TAMs are often elicited by alternative activation, which polarizes cells toward regulatory macrophages, a subgroup of the so-called M2 phenotype. They share anti-inflammatory characteristic, for example, reduced interleukin (IL)-12 production 2,3 compared with classical stimulation and M1 polarization. 2 Unfortunately, it is only poorly understood which factors influence the TAM phenotype profile. The phenotype alteration occurs in the tumor microenvironment, with the likely contribution of tumor-derived molecules such as IL-4, IL-10, transforming growth factor (TGF)-, prostaglandin E 2 (PGE 2 ), chemokines, or tumor hypoxia. 1,2 Interestingly, apoptotic cells (AC) also release anti-inflammatory cytokines such as TGF- and IL-10 4,5 and reduce tumor-directed macrophage cytotoxicity. 6 It became apparent that phagocytosis of AC by macrophages is an immunoregulatory process that shapes the regulatory macrophage phenotype. [7][8][9][10] Macrophages cocultured in vitro with AC or exposed to the supernatant of AC express a pattern of markers that overlaps with those established for TAMs. [11][12][13] Furthermore, sphingosine-1-phosphate (S1P) provoked M2 macrophage polarization, 13,14 and S1P is released from AC. 13,15 S1P activates distinct G proteincoupled receptors, 16 elicits a variety of immune cell responses, 17 and promotes tumor angiogenesis. 18,19 Hypoxia-inducible factor (HIF)-1 is known for its importance in tumorigenesis, and controls angiogenesis, proliferation, metabolism, metastasis, and differentiation. 20 HIF-1, composed of a HIF-1␣ and HIF-1 subunit, senses and coordinates adaptation to low oxygen availability. Under normoxia (21% O 2 ), HIF-1 is constitutively expressed, whereas HIF-1␣ is hydroxylated by prolyl hydroxylases, polyubiquitinated by an E3-ubiquitin ligase complex containing the von Hippel Lindau protein, and concomitantly degraded (for review, see Semenza 21 ). Because hypoxia mainly affects HIF-1␣ protein stability, HIF-1␣ mRNA expression regulation only recently attracted some interest. In macrophages, lipopolysaccharide (LPS) induced nuclear factor (NF)-B binding to the HIF-1␣ promoter and increased its mRNA expression. 22 Nuclear factor of activated T cells (NFAT)c1 increased the HIF-␣ mRNA content in mast cells after stimulation with ionomycin, 23 and signal transducer and activator of transcription (STAT)3 up-regulated HIF-1␣ mRNA in human tumor cells, 24 substantiating the importance of transcriptional control mechanisms governing HIF-1 appearance/activity.We provide evidence that HIF-1␣ under normoxia is transcriptionally activated via NFAT in response to apoptotic cell-derived S1P and TGF-. As verified in cells from HIF-1␣ conditional knockout mice, activation of HIF-1 in pola...