MACROPHAGES IN ACUTE MYOCARDIAL INFARCTION: HETEROGENEITY AND TARGETED THERAPIES

Authors

  • HaoDi Fu Department of Cardiovascular Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China.
  • YiHuan Chen (Corresponding Author) Department of Cardiovascular Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China.

Keywords:

Myocardial infarction, Macrophages, Ventricular remodeling, Immunotherapy

Abstract

Cardiac repair after acute myocardial infarction depends on the precise regulation of the immune microenvironment. Macrophages are now understood beyond the M1/M2 dichotomy, with dual origins and a continuous functional spectrum. This review summarizes the spatiotemporal roles of cardiac resident and monocyte-derived macrophages, as well as their coordination in the resolution of inflammation, tissue repair, and scar maturation. It also outlines new therapeutic strategies targeting the recruitment of macrophages, their phenotypic transition, and metabolic reprogramming to improve post-infarction cardiac remodeling.

References

[1] Vaduganathan M, Mensah G A, Turco J V, et al. The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health. Journal of the American College of Cardiology, 2022, 80(25): 2361-2371.

[2] Zhang W, Lavine K J, Epelman S, et al. Necrotic myocardial cells release damage-associated molecular patterns that provoke fibroblast activation in vitro and trigger myocardial inflammation and fibrosis in vivo. Journal of the American Heart Association, 2015, 4(6): e001993.

[3] Bergmann O, Bhardwaj R D, Bernard S, et al. Evidence for cardiomyocyte renewal in humans. Science, 2009, 324(5923): 98-102.

[4] Sim H W, Zheng H, Richards A M, et al. Beta-blockers and renin-angiotensin system inhibitors in acute myocardial infarction managed with inhospital coronary revascularization. Scientific Reports, 2020, 10(1): 15184.

[5] Butler J, Hammonds K, Talha K M, et al. Incident heart failure and recurrent coronary events following acute myocardial infarction. European Heart Journal, 2025, 46(16): 1540-1550.

[6] Pinto A R, Ilinykh A, Ivey M J, et al. Revisiting Cardiac Cellular Composition. Circulation Research, 2016, 118(3): 400-409.

[7] Lavine K J, Pinto A R, Epelman S, et al. The Macrophage in Cardiac Homeostasis and Disease: JACC Macrophage in CVD Series (Part 4). Journal of the American College of Cardiology, 2018, 72(18): 2213-2230.

[8] Martinez F O, Helming L, Milde R, et al. Genetic programs expressed in resting and IL-4 alternatively activated mouse and human macrophages: similarities and differences. Blood, 2013, 121(9): e57-e69.

[9] Murray P J, Allen J E, Biswas S K, et al. Macrophage activation and polarization: nomenclature and experimental guidelines. Immunity, 2014, 41(1): 14-20.

[10] Bajpai G, Schneider C, Wong N, et al. The human heart contains distinct macrophage subsets with divergent origins and functions. Nature Medicine, 2018, 24(8): 1234-1245.

[11] Jung S H, Hwang B H, Shin S, et al. Spatiotemporal dynamics of macrophage heterogeneity and a potential function of Trem2(hi) macrophages in infarcted hearts. Nature Communications, 2022, 13(1): 4580.

[12] Dick S A, Macklin J A, Nejat S, et al. Self-renewing resident cardiac macrophages limit adverse remodeling following myocardial infarction. Nature Immunology, 2019, 20(1): 29-39.

[13] Epelman S, Lavine K J, Beaudin A E, et al. Embryonic and adult-derived resident cardiac macrophages are maintained through distinct mechanisms at steady state and during inflammation. Immunity, 2014, 40(1): 91-104.

[14] Koenig A L, Kadyrov F F, Amrute J M, et al. Genetic Mapping of Monocyte Fate Decisions Following Myocardial Infarction. bioRxiv, 2025.

[15] Heidt T, Courties G, Dutta P, et al. Differential contribution of monocytes to heart macrophages in steady-state and after myocardial infarction. Circulation Research, 2014, 115(2): 284-295.

[16] Kitahara T, Takeishi Y, Harada M, et al. High-mobility group box 1 restores cardiac function after myocardial infarction in transgenic mice. Cardiovascular Research, 2008, 80(1): 40-46.

[17] Chalise U, Becirovic-Agic M, Daseke M J, 2nd, et al. S100A9 is a functional effector of infarct wall thinning after myocardial infarction. American Journal of Physiology-Heart and Circulatory Physiology, 2022, 322(2): H145-H155.

[18] Nahrendorf M, Swirski F K, Aikawa E, et al. The healing myocardium sequentially mobilizes two monocyte subsets with divergent and complementary functions. Journal of Experimental Medicine, 2007, 204(12): 3037-3047.

[19] Anzai A, Choi J L, He S, et al. The infarcted myocardium solicits GM-CSF for the detrimental oversupply of inflammatory leukocytes. Journal of Experimental Medicine, 2017, 214(11): 3293-3310.

[20] Heusch G, Kleinbongard P. The spleen in ischaemic heart disease. Nature Reviews Cardiology, 2025, 22(7): 497-509.

[21] Swirski F K, Nahrendorf M, Etzrodt M, et al. Identification of splenic reservoir monocytes and their deployment to inflammatory sites. Science, 2009, 325(5940): 612-616.

[22] Leuschner F, Panizzi P, Chico-Calero I, et al. Angiotensin-converting enzyme inhibition prevents the release of monocytes from their splenic reservoir in mice with myocardial infarction. Circulation Research, 2010, 107(11): 1364-1373.

[23] Majmudar M D, Keliher E J, Heidt T, et al. Monocyte-directed RNAi targeting CCR2 improves infarct healing in atherosclerosis-prone mice. Circulation, 2013, 127(20): 2038-2046.

[24] Hilgendorf I, Gerhardt L M, Tan T C, et al. Ly-6C^high monocytes depend on Nr4a1 to balance both inflammatory and reparative phases in the infarcted myocardium. Circulation Research, 2014, 114(10): 1611-1622.

[25] Panizzi P, Swirski F K, Figueiredo J L, et al. Impaired infarct healing in atherosclerotic mice with Ly-6C(hi) monocytosis. Journal of the American College of Cardiology, 2010, 55(15): 1629-1638.

[26] Wu Y, Wei P, Li B, et al. Temporal dynamics of the multi-omic response reveals the modulation of macrophage subsets post-myocardial infarction. Journal of Translational Medicine, 2025, 23(1): 777.

[27] Mills C D, Kincaid K, Alt J M, et al. M-1/M-2 macrophages and the Th1/Th2 paradigm. Journal of Immunology, 2000, 164(12): 6166-6173.

[28] Varinou L, Ramsauer K, Karaghiosoff M, et al. Phosphorylation of the Stat1 transactivation domain is required for full-fledged IFN-gamma-dependent innate immunity. Immunity, 2003, 19(6): 793-802.

[29] Yang S H, Li L, Xie Y Q, et al. IFN-γ-STAT1-iNOS Induces Myeloid Progenitors to Acquire Immunosuppressive Activity. Frontiers in Immunology, 2017, 8: 1192.

[30] Sakai J, Cammarota E, Wright J A, et al. Lipopolysaccharide-induced NF-κB nuclear translocation is primarily dependent on MyD88, but TNFα expre

Downloads

Published

2025-12-18

Issue

Section

Research Article

DOI:

How to Cite

Fu, H., Chen, Y. (2025). Macrophages In Acute Myocardial Infarction: Heterogeneity And Targeted Therapies. Eurasia Journal of Science and Technology, 7(3), 61-70. https://doi.org/10.61784/jpmr3058