Macrophages in Tissue Repair, Regeneration, and Fibrosis
Open accessAbstract
Inflammatory monocytes and resident tissue macrophages are key regulators of tissue repair, regeneration, and fibrosis. Following tissue injury, monocytes and macrophages undergo marked phenotypic and functional changes to play critical roles during the initiation, maintenance, and resolution phases of tissue repair. Disturbances in macrophage function can lead to aberrant repair, with uncontrolled inflammatory mediator and growth factor production, deficient generation of anti-inflammatory macrophages, or failed communication between macrophages and epithelial cells, endothelial cells, fibroblasts, and stem or tissue progenitor cells all contributing to a state of persistent injury, which may lead to the development of pathological fibrosis. In this review, we discuss the mechanisms that instruct macrophages to adopt pro-inflammatory, pro-wound healing, pro-fibrotic, anti-inflammatory, anti-fibrotic, pro-resolving, and tissue regenerating phenotypes following injury, and highlight how some of these mechanisms and macrophage activation states could be exploited therapeutically.
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M1 and M2 macrophages play coordinating roles in the wound healing process by secreting cytokines such as IL-6, TGF-β, TNF-α, and IL-8 to mobilize peripheral or systemic monocytes and lymphocytes to gather around the wound surface.
“M1 and M2 macrophages also play coordinating roles in the wound healing process by secreting cytokines, such as IL-6, transforming growth factor-β (TGF-β), tumor necrosis factor-α (TNF-α), and IL-8, to mobilize peripheral or systemic monocytes and lymphocytes to gather around the wound surface (Snyder et al., 2016;Wynn and Vannella, 2016).”
From Nanosilver alleviates foreign body reaction and facilitates wound repair by regulating macrophage polarization (2023) · cites this paper as Wynn and Vannella, 2016
The Introduction (page unavailable) says macrophages of different phenotypes regulate stages of wound repair and produce inflammatory mediators; it also identifies TGF-β1 as a product of wound-healing macrophages. The Tissue Regeneration section (page unavailable) describes TNF-α-producing inflammatory macrophages, but says CCL2 from neighboring hair follicles recruits them. These passages do not support the specific claim that macrophage-secreted IL-6, TGF-β, TNF-α, and IL-8 mobilize monocytes and lymphocytes to the wound surface. (LLM, conf=0.85)
Experimental — accuracy not yet measuredM1 macrophages secrete numerous proteolytic enzymes to degrade extracellular matrix (ECM), including collagens, elastin, and fibronectin.
“M1 macrophages secrete numerous proteolytic enzymes to degrade extracellular matrix (ECM), including collagens, elastin, and fibronectin.”
From Nanosilver alleviates foreign body reaction and facilitates wound repair by regulating macrophage polarization (2023) · cites this paper as Wynn and Vannella, 2016
The Introduction says macrophages produce matrix metalloproteinases, and “Regulation and function of pro-fibrotic macrophages” says these enzymes degrade ECM proteins and identifies a macrophage-secreted elastase. The paper does not assign this activity specifically to M1 macrophages or explicitly identify collagen and fibronectin as substrates. (LLM, conf=0.85)
Experimental — accuracy not yet measuredM2 macrophages secrete ECM cross-linking enzymes, such as glutaminyl transferase and osteopontin, which promote ECM and cell adhesion.
“M2 macrophages secrete ECM cross-linking enzymes, such as glutaminyl transferase and osteopontin, which promote ECM and cell adhesion”
From Nanosilver alleviates foreign body reaction and facilitates wound repair by regulating macrophage polarization (2023) · cites this paper as Wynn and Vannella, 2016
The section “Regulation and function of pro-fibrotic macrophages” (page unavailable) says M(IL-4) macrophages regulate collagen fibril assembly and that loss of IL-4Rα signaling diminishes induction of lysyl hydroxylase 2, an enzyme involved in collagen cross-links. It does not say these macrophages secrete glutaminyl transferase or osteopontin, or that those substances promote ECM and cell adhesion. (LLM, conf=0.86)
Experimental — accuracy not yet measuredBoth M1 and M2 macrophages play important roles in collagen deposition.
“suggesting that both macrophages play important roles in collagen deposition (Wynn and Vannella, 2016;Hesketh et al., 2017;Liu et al., 2021).”
From Nanosilver alleviates foreign body reaction and facilitates wound repair by regulating macrophage polarization (2023) · cites this paper as Wynn and Vannella, 2016
In “Regulation and function of pro-fibrotic macrophages” (page not available), the review says collagen fibril assembly during skin repair depends on M(IL-4) macrophages, broadly corresponding to M2. It also says inflammatory monocytes can promote fibrosis, but does not establish that M1 macrophages play an important role in collagen deposition specifically. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMacrophage polarization is instructed by biomechanical properties of the fibrotic microenvironment, including matrix stiffness, fluid shear stress, and intercellular tension, through integrin/FAK, Piezo1/TRPV4, YAP/TAZ, NF-kB, and ROCK signaling.
“Beyond biochemical cues, the biomechanical properties of the fibrotic microenvironment-notably increased matrix stiffness, fluid shear stress, and intercellular tension-are now recognized as active instructors of macrophage polarization (6,74,75).”
From The mechanotransduction-immune axis in organ fibrosis: dual regulatory mechanisms and translational therapeutic perspectives (2025) · cites this paper as [74]
Pro-fibrotic macrophages commonly coordinate scar formation via interactions with fibroblasts, the major cellular source of pathological extracellular matrix deposition during fibrosis.
“pro-fibrotic macrophages commonly coordinate scar formation via a range of interactions with fibroblasts, the major cellular source of pathological extracellular matrix deposition during fibrosis18,27,74–78.”
From Fibrosis: from mechanisms to medicines (2020) · cites this paper as [76]
M2 macrophages promote fibroproliferation and uncontrolled repair.
“M1 macrophages suppress, and M2 macrophages promote, fibroproliferation and uncontrolled repair (17).”
From The Role of Immune and Inflammatory Cells in Idiopathic Pulmonary Fibrosis (2018) · cites this paper as [17]
M1 macrophages suppress fibroproliferation and uncontrolled repair.
“M1 macrophages suppress, and M2 macrophages promote, fibroproliferation and uncontrolled repair (17).”
From The Role of Immune and Inflammatory Cells in Idiopathic Pulmonary Fibrosis (2018) · cites this paper as [17]
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- Authors
- Wynn, T. A., & Vannella, K. M.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Wynn, Thomas A.
- Venue
- Immunity
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 44
- Issue
- 3
- Pages
- 450-462
- ISSN
- 1074-7613 (ISSN-L)
- PMC
- PMC4794754
- OpenAlex
- W2301044272
- Semantic Scholar
- 3e7cc72db53c49f88a543c99b71749931fb6c7b0
- Cited by
- 4,481
- References
- 129
- Citations by year
- 2026: 673 · 2025: 638 · 2024: 564 · 2023: 511 · 2022: 504 · 2021: 475 · 2020: 399 · 2019: 299 · 2018: 228 · 2017: 136 · 2016: 35 · 2015: 1 · 2014: 1 · 2012: 2
- FWCI
- 29.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Immunity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Allergy and Infectious Diseases (Z01AI001019, Z01AI000829)
- Topics
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- macrophages, tissue repair, tissue regeneration, fibrosis, inflammatory monocytes, macrophage polarization, wound healing, inflammation resolution, macrophage-targeted therapy
- MeSH terms
- Animals, Cell Communication, Cell Differentiation, Fibrosis, Humans, Macrophage Activation, Macrophages, Phenotype, Regeneration, Wound Healing
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