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December 4, 2024Cell Death Discovery113 citationsOpen Access

Macrophages in organ fibrosis: from pathogenesis to therapeutic targets

YJYuanyuan JiangRCRong CaiYHYu Huang

Key Points

  • To examine the mechanistic relationship between macrophage plasticity and the development of organ fibrosis, and to evaluate macrophage-targeted therapeutic strategies.
  • Narrative review synthesizing current mechanistic evidence on chronic inflammation, parenchymal injury, and macrophage recruitment across major organs including the heart, liver, kidney, and lungs.
  • Diverse organ fibrosis subtypes share conserved pathways featuring chronic inflammation, parenchymal cell damage, and marked macrophage infiltration.
  • High macrophage plasticity enables microenvironment-driven phenotypic polarization, which critically drives fibrotic tissue remodeling and subsequent organ failure.
  • Therapeutic interventions specifically modulating macrophage recruitment, activation, and phenotypic switching show promise in halting or reversing progressive tissue fibrosis.

Abstract

Fibrosis, an excessive self-repair response, is an age-related pathological process that universally affects various major organs such as the heart, liver, kidney, and lungs. Continuous accumulation of pathological tissue fibrosis destroys structural integrity and causes loss of function, with consequent organ failure and increased mortality. Although some differences exist in the triggering mechanisms and pathophysiologic manifestations of organ-specific fibrosis, they usually share similar cascading responses and features, including chronic inflammatory stimulation, parenchymal cell injury, and macrophage recruitment. Macrophages, due to their high plasticity, can polarize into different phenotypes in response to varied microenvironments and play a crucial role in the development of organ fibrosis. This review examined the relationship between macrophages and the pathogenesis of organ fibrosis. Moreover, it analyzed how fibrosis can be modulated by targeting macrophages, which may become a novel and promising therapeutic strategy for fibrosis.

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Cite This Study

Jiang et al. (2024) studied this question.

synapsesocial.com/papers/69dd5c697808b00a4799cfc1https://doi.org/10.1038/s41420-024-02247-1
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