巨噬细胞具有多种亚型。经典激活的巨噬细胞(M1)和替代激活的巨噬细胞(M2)是巨噬细胞不均一性的两种极端分类,分别由Th1和Th2细胞因子激活。M1和M2巨噬细胞的表面标志物、产生的细胞因子和趋化因子及其功能都有明显不同。巨噬细胞的极化由多种分子调控,转录因子是其中最重要的群体之一。极化的巨噬细胞存在于不同的微环境中,扮演着不同角色。身体的代谢状态在很大程度上取决于极化的巨噬细胞和脂肪细胞、肝细胞、骨骼肌细胞之间的相互作用。这些相互作用对2型糖尿病的发生发展起重要作用。极化的巨噬细胞和血管平滑肌细胞、内皮细胞、心肌细胞之间的相互作用很可能会影响心血管疾病的发生发展。这些相互作用导致抗炎的M2巨噬细胞通常在2型糖尿病和心血管疾病中发挥保护作用。这些研究进一步拓展了对生理和病理上巨噬细胞极化功能的认识,并提示了众多临床治疗设想。
Macrophages are categorized into phenotypic subtypes. Classically activated macrophages (M1) and altematively activated macrophages (M2) are the two extremes of the full spectrum of macrophage heterogeneity. They are activated by Thl and Th2 cytokines respectively. Surface markers, cytokine and chemokine production, and functions are distinctly different between M1 and M2 macrophages. Macrophage polarization is tightly regulated by a variety of molecules, among which transcription factors are one of the most important group. Polarized macrophages exist in different microenvironments and play different roles. The metabolic status of the body is largely determined by the crosstalk between polarized macrophages and adipocytes, hepatocytes, and skeletal myocytes. Furthermore, such crosstalk plays important roles in the development of type 2 diabetes. The interactions between polarized macrophages and vascular smooth muscle cells, endothelial cells, and possibly cardiomyocytes contribute to the development of cardiovascular disease. The outcome of these interactions indicates that in general anti-inflammatory M2 macrophages play protective roles in type 2 diabetes and cardiovascular disease. These studies have tremendously advanced our appreciation of the function of macrophage polarization in physiology and pathology and presented numerous therapeutic opportunities.