With increasing interest in alternative options to interferon-alpha-based treatments, IFN-λ has shown therapeutic promise in a variety of diseases. Although the antiviral activity of IFN-λ has been extensively studied, there is limited knowledge regarding the immunological functions of IFN-λ and how these differ from those of other classes of IFNs.In this study, we investigated the effects of IFN-λ on primary human NK cells, both in a direct and indirect capacity. We demonstrate that in contrast to interferon-alpha, IFN-λ is unable to directly stimulate NK cells, due to the absence of IFN-λ receptor chain 1 (IFN-λR1) on NK cells. However, IFN-λ, in combination with TLR4 challenge, is able to induce the production of select members of the IL-12 family of cytokines in monocyte-derived macrophages. We further show that through macrophage-mediated IL-12 production, IFN-λ is able to indirectly affect NK cells and ultimately induce IFN-γ production.Keywords: Hepatitis C r IFN-γ r IL-29 r Innate immunity r Macrophages r NK cells Additional supporting information may be found in the online version of this article at the publisher's web-site Introduction NK cells play an important role in the innate immune response, specifically in their ability to recognize and respond to stressed cells, including virus-infected, transformed, and damaged cells. Activated NK cells respond to these stress signals by excretion of cytotoxic factors, including perforin and granzymes, as well as cytokines, such as interferon-γ (IFN-γ) and TNF, that act as a first response to control the source of distress as well as to activate subsequent adaptive immune responses [1,2]. NK cells express an Correspondence: Dr. André Boonstra e-mail: p.a.boonstra@erasmusmc.nl array of activating receptors, such as C-type lectin-like receptors (e.g. NKG2D) and natural cytotoxicity receptors, and inhibiting receptors, C-type lectin-like receptors (e.g. NKG2A) and killer cell immunoglobulin-like receptor. It is currently believed that NK-cell activation or inhibition is governed by a balance of signaling by these receptors, and results after a critical threshold of activation signals exceeds inhibition [3].NK-cell activation ensues after interacting with infected or distressed cells, shifting the balance of inhibitory and activating stimuli delivered via specific surface molecules. These include stressinduced surface markers, including altered MHC expression, as well as soluble factors, of which IL-12 and IL-18 are well described and known triggers of NK-cell effector activity [1,2,4] In line with this, the activity of NK cells can be promoted by exposure to interferon-alpha (IFN-α), e.g. during interaction with IFN-producing activated plasmacytoid DCs leading to enhanced activation and cytolytic activity [9][10][11], and thereby promoting antiviral immunity. In recent years, the type III family of IFNs, comprised IFN-λ1, IFN-λ2, IFN-λ3, and IFN-λ4, has received increased attention, especially after the discovery of polymorphisms within its gene locus that were a...