A macrophage-activating factor (MAF) is a

lymphokine Lymphokines are a subset of cytokines that are produced by a type of immune cell known as a lymphocyte. They are protein mediators typically produced by T cells to direct the immune system response by signaling between its cells. Lymphokines have ...

or other receptor based signal that primes macrophages towards cytotoxicity to

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

cytokine Cytokines are a broad and loose category of small proteins (~5–25 kDa) important in cell signaling. Cytokines are peptides and cannot cross the lipid bilayer of cells to enter the cytoplasm. Cytokines have been shown to be involved in a ...

secretion, or clearance of pathogens. Similar molecules may cause development of an inhibitory, regulatory phenotype. A MAF can also alter the ability of macrophages to present MHC I antigen, participate in Th responses, and/or affect other immune responses. MAFs act typically in combination to produce a specific phenotype.

Macrophage activated phenotypes

Macrophages inherently display tissue and environment-dependent plasticity. In addition, the phenotypes of the macrophages in a certain environment play a fundamental role in determining the immune activity and response within the tissue. Depending on the combination of MAFs signaling to the macrophage, the macrophage’s activated phenotype becomes one of three major categories: classically activated, wound healing, or regulatory. Regulatory-phenotype macrophages have only recently been recognized as an important contributor to tissue microenvironments.

Tumor-associated macrophage Tumor-associated macrophages (TAMs) are a class of immune cells present in high numbers in the microenvironment of solid tumors. They are heavily involved in cancer-related inflammation. Macrophages are known to originate from bone marrow-derived bl ...

s may be any of these types, and they have been found to be important players in the tumor microenvironment. Analysis of the macrophage population and signaling in a tumor may provide useful clinical data.

Clarifications on terminology

*Macrophages have been classified as M1 or M2 depending on the adaptive immune response that elicited the phenotype: Th1 or Th2 respectively. *The phrase 'alternatively activated macrophage' is used to refer to M2 macrophages. *Regulatory macrophages do not fit into the M1/M2 classification system, and they display different markers.

Classically activated macrophages

After receiving signaling from both

IFNγ Interferon gamma (IFN-γ) is a dimerized soluble cytokine that is the only member of the type II class of interferons. The existence of this interferon, which early in its history was known as immune interferon, was described by E. F. Wheelock ...

and TNF, macrophages acquire a phenotype with higher activity against both pathogens and tumor cells. They also secrete inflammatory cytokines. IFNγ signaling can initially originate from Natural Killer (NK) cells, but adaptive immune cells are required to sustain a population of classically activated macrophages.

Toll-like receptor Toll-like receptors (TLRs) are a class of proteins that play a key role in the innate immune system. They are single-pass membrane-spanning receptors usually expressed on sentinel cells such as macrophages and dendritic cells, that recogniz ...

agonists may also cause macrophage activation.

Wound healing macrophages

Interleukin 4 The interleukin 4 (IL4, IL-4) is a cytokine that induces differentiation of naive helper T cells ( Th0 cells) to Th2 cells. Upon activation by IL-4, Th2 cells subsequently produce additional IL-4 in a positive feedback loop. IL-4 ...

, secreted by granulocytes after tissue damage or by adaptive immune cells within a Th2 response, causes macrophages to secrete minimal amounts of pro-inflammatory cytokines and to have lower activity against intracellular pathogens. They also promote

extracellular matrix In biology, the extracellular matrix (ECM), also called intercellular matrix, is a three-dimensional network consisting of extracellular macromolecules and minerals, such as collagen, enzymes, glycoproteins and hydroxyapatite that provide struc ...

synthesis via production of

ornithine Ornithine is a non-proteinogenic amino acid that plays a role in the urea cycle. Ornithine is abnormally accumulated in the body in ornithine transcarbamylase deficiency. The radical is ornithyl. Role in urea cycle L-Ornithine is one of the prod ...

, via

arginase Arginase (, ''arginine amidinase'', ''canavanase'', ''L-arginase'', ''arginine transamidinase'') is a manganese-containing enzyme. The reaction catalyzed by this enzyme is: : arginine + H2O → ornithine + urea It is the final enzyme of the ure ...

; this is used as a precursor for extracellular matrix components. The overall result is a macrophage population that promotes wound healing. The specific roles macrophages play in the Th2 response are still under investigation.

Regulatory macrophages

Glucocorticoid Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every verte ...

s can contribute to the development of regulatory macrophages. These macrophages produce

Interleukin 10 Interleukin 10 (IL-10), also known as human cytokine synthesis inhibitory factor (CSIF), is an anti- inflammatory cytokine. In humans, interleukin 10 is encoded by the ''IL10'' gene. IL-10 signals through a receptor complex consisting of two IL-10 ...

and inhibit immune system response (See below for Effect on cancer). Tumor-associated macrophages may contain a large population of regulatory macrophages.

Effect on cancer

Initially, MAFs were thought to increase a macrophage’s cytotoxic response, allowing enhanced clearance of the tumor cells. However, they also have wider ranging effects. Chronic inflammation associated with activated macrophages may lead to the development of

neoplasia A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

, such as those found surrounding tuberculosis scars. Dysregulation of macrophage activation may cause increased inflammation and eventual neoplasia. Moreover, macrophages infiltrating the tumor microenvironment can transition towards a regulatory phenotype. Regulatory macrophages produce

, which can inhibit cytotoxic responses of other lymphocytes to cancer cell antigens. The stromal reaction surrounding a tumor, as well as

prostaglandin The prostaglandins (PG) are a group of physiologically active lipid compounds called eicosanoids having diverse hormone-like effects in animals. Prostaglandins have been found in almost every tissue in humans and other animals. They are der ...

s and hypoxia may play a role in this transition. Epithelial-mesenchymal transition has been found to be influenced by all types of macrophages, which cause both pro and anti-inflammatory responses that can promote EMT.

Non-cytokine examples of macrophage-activating factors

Pathogenic antigens can bind to

toll-like receptor Toll-like receptors (TLRs) are a class of proteins that play a key role in the innate immune system. They are single-pass membrane-spanning receptors usually expressed on sentinel cells such as macrophages and dendritic cells, that recogniz ...

s that stimulate macrophage activation and response. Examples include

heat shock protein Heat shock proteins (HSP) are a family of proteins produced by cells in response to exposure to stressful conditions. They were first described in relation to heat shock, but are now known to also be expressed during other stresses including exp ...

s released during apoptosis, and bacterial lipopolysaccharide.

Examples

Interferon-gamma Interferon gamma (IFN-γ) is a dimerized soluble cytokine that is the only member of the type II class of interferons. The existence of this interferon, which early in its history was known as immune interferon, was described by E. F. Wheelock ...

TNF alpha Tumor necrosis factor (TNF, cachexin, or cachectin; formerly known as tumor necrosis factor alpha or TNF-α) is an adipokine and a cytokine. TNF is a member of the TNF superfamily, which consists of various transmembrane proteins with a homologo ...

CD36 CD36 (cluster of differentiation 36), also known as platelet glycoprotein 4, fatty acid translocase (FAT), scavenger receptor class B member 3 (SCARB3), and glycoproteins 88 (GP88), IIIb (GPIIIB), or IV (GPIV) is a protein that in humans is enco ...

Miscellaneous

It has been suggested that MAF can be formed by probiotic bacteria in a yoghurt medium. This probiotic mixture has been found to be helpful in various immune disturbances including ME/CFS.

References

External links

* {{MeshName, Macrophage-Activating+Factors Cytokines