The role of macrophages in repair of injured myocardium and perspectives of metabolic reprogramming of immune cells for myocardial post-infarction recovery

Abstract

A new trend in modern experimental cardiology is the development of approaches to correction of reparation after myocardial infarction (MI) with the use of specific effects on immune cells. One of the main targets for such interventions is the process of macrophage’s polarization in the infarction zone. Proinflammatory M1‑macrophages contribute to hampered myocardial re‑ pair, in contrast to M2‑macrophages that promote regeneration. Currently, there are two main ways of targeted delivery of agents necessary for macrophage reprogramming – inlipoid and inglycan‑encapsulated particles. As modulating agents, small interfering RNA and other genetic constructions are usually used. Both these approaches are currently awaiting their translation into car‑ diology. The most physiological approach to reprogramming of immune cells may consist in attempts to switch the metabolism of the immune cell from glycolytic to oxidative, which allows macrophages to switch from M1 to M2 phenotype. Among possible targets for macrophage reprogramming, it is worthwhile to isolate the protein complex mTORC1, the blocking of which pro‑ motes oxidative metabolism, and the transcription factor HIF‑1α, the blocking of which also facilitates the switching of the me‑ tabolism from glycolytic to oxidative one.