Infection of C3H mice with Borrelia burgdorferi, the causative agent of Lyme disease, reliably produces an infectious arthritis and carditis that peak around 3 weeks postinfection and then spontaneously resolve. Macrophage polarization has been suggested to drive inflammation, the clearance of bacteria, and tissue repair and resolution in a variety of infectious disease models. During Lyme disease it is clear that macrophages are capable of clearing Borrelia spirochetes and exhausted neutrophils; however, the role of macrophage phenotype in disease development or resolution has not been studied. Using classical (NOS2) and alternative (CD206) macrophage subset-specific markers, we determined the phenotype of F4/80 ؉ macrophages within the joints and heart throughout the infection time course. Within the joint, CD206؉ macrophages dominated throughout the course of infection, and NOS2؉ macrophage numbers became elevated only during the peak of inflammation. We also found dual NOS2 ؉ CD206 ؉ macrophages which increased during resolution. In contrast to findings for the ankle joints, numbers of NOS2 ؉ and CD206؉ macrophages in the heart were similar at the peak of inflammation. 5-Lipoxygenase-deficient (5-LOX ؊/؊ ) mice, which display a failure of Lyme arthritis resolution, recruited fewer F4/80 ؉ cells to the infected joints and heart, but macrophage subset populations were unchanged. These results highlight differences in the inflammatory infiltrates during Lyme arthritis and carditis and demonstrate the coexistence of multiple macrophage subsets within a single inflammatory site.
Macrophages play a dynamic role in the immune system as both inflammatory and anti-inflammatory mediators. Their phenotype is highly flexible and dependent upon the cytokine stimulus of the microenvironment they infiltrate (1). They are routinely classified as proinflammatory and immunomodulatory (M1) or anti-inflammatory and remodeling (M2) macrophages, but their phenotype actually lies within a spectrum of inflammatory to anti-inflammatory polarization (2). The language within the field is currently being modified to ensure that the macrophages being studied have a clear phenotypic description, and we use the nomenclature recently suggested (3). Within the last 15 years, much work has been done to phenotypically characterize macrophage subsets. Identifying unique surface and intracellular markers, as well as understanding transcriptional regulation, has allowed the importance of specific macrophage phenotypes in infectious and autoimmune models to be uncovered.Classically activated M1 macrophages are proinflammatory cells capable of destroying pathogens, tumor cells, and various foreign compounds. Stimulation of undifferentiated macrophages with lipopolysaccharide (LPS) and gamma interferon (IFN-␥), or tumor necrosis factor alpha (TNF-␣), induces polarization to the M1 phenotype (4, 5). They can be recognized both in vitro and in vivo by the production of nitric oxide species (NOS), as well as other proinflammatory molecules, including ...