The main challenge of metabolic pathways has always been their complexity. This stems from the number of metabolites (which intracellularly can run into the thousands), their chemical complexity, and the sophisticated regulation of the enzymes that control them. Recent discoveries on the role of metabolic pathways in immune cell function have brought the burgeoning area of immunometabolism to the forefront for many immunologists. In this review, we will discuss recent findings in macrophages and DCs, critical cell types for both innate and adaptive immunity. A primary goal for immunologists is to uncover the molecular players in processes that provide a detailed account of how the effector functions of immune cells are controlled. These processes become dysregulated in disease. The analysis of metabolic reprogramming in macrophages and DCs provides new insights into how these cells perform their functions, including cytokine production, phagocytosis, or antigen presentation. The somewhat surprising finding is that metabolic processes such as glycolysis, the Krebs cycle, and fatty acid metabolism have highly specific effects on macrophage and DC function. The manipulation of these pathways can dramatically alter the functioning of these cells in specific ways, rather than simply being involved in energy generation or general biosynthesis. Metabolic reprogramming as a phenomenon is therefore joining other key immunoregulatory events that govern the nature of the immune response, both in health and disease.
What is metabolic reprogramming?A simple view of metabolic reprogramming is that it reflects the responses of cells to critical changes in the environment. For example, under normoxic conditions, cells can use oxidative phosphorylation (OXP HOS) to generate ATP. Critical components of the electron transport chain (ETC) use NADH and FADH generated as a result of reactions in the Krebs cycle, which in turn is fueled by glucose, fatty acids, and glutamine. In contrast, when O 2 tensions are low, cells can to a greater or lesser degree generate ATP through glycolysis and independently of OXP HOS, but this pathway is highly dependent on glucose as a sole fuel source. The core metabolic pathways are essential for interchanging carbons between sugars, fatty acids, nucleic acids, and proteins, and therefore, metabolic flexibility can play a critical role as prevailing nutrient and oxygen conditions change. This can be of great importance if a cell is faced with differing functional demands. A critical point from the perspective of this review is that recent work has emphasized the fact that changes in key metabolic regulatory events in immune cells can be initiated not only by nutrient and oxygen conditions, but also in reprogramming events downstream of ligation of pattern recognition receptors (PRRs), cytokine receptors, and/or Ag receptors (and likely other receptors). Thus, in immune cells, there is the potential for metabolic changes to occur in response to instructional signals received from other cells or from ch...