Key result
Targeting NR4A1 promotes reparative M2 macrophage polarization as a potential therapy for post-MI cardiac repair.
Why the study?
Sterile inflammation during myocardial infarction contributes to cardiac remodeling and heart failure, making macrophage polarization to a reparative M2 phenotype key to tissue repair.
Targeting NR4A1 to modulate macrophage polarization represents a promising but complex translational strategy for promoting cardiac repair and preventing adverse remodeling after myocardial infarction.
Sterile inflammation in the course of myocardial infarction can be a factor contributing to cardiac remodeling and heart failure. To break this pathological vicious circle, the polarization of macrophages to a reparative M2 phenotype, to start the tissue repair process and alleviate the inflammation, is the key. Recent studies have shown that the nuclear receptor subfamily 4 group A (NR4A) orphan nuclear receptor family, particularly nuclear receptor subfamily 4 group A member 1 (NR4A1/NUR77), plays a role in macrophage reprogramming in relation to the modulation of macrophage polarization. Herein, we discuss in detail the specific pathways regulated by NR4A receptors during cellular reprogramming, including the nuclear factor kappa B (NF-κB) pathway and the oxidative phosphorylation pathway. We list below the beneficial effects of NR4A-treated macrophages in the hypoxic cardiac tissue, including their essential contribution to the formation of a neovascular network, the maintenance of the extracellular matrix by fibroblasts, and the direct rescue of remaining cardiomyocytes. In addition, given the translational potential of targeted therapy with immunomodulatory molecules against NR4A, we also review the design of macrophage-specific nanodelivery systems and the creation of novel small-molecule activators for ischemic cardiovascular diseases to identify therapeutic targets for cardiac repair based on NR4A.
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Lin et al. (2026) conducted a review in Myocardial infarction. NR4A1 (Nur77) modulation was evaluated. Targeting NR4A1 (Nur77) promotes macrophage polarization toward a reparative M2 phenotype, offering a potential therapeutic strategy for cardiac repair after myocardial infarction.
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