A central component of sepsis pathophysiology is the polarization of macrophages. Macrophages undergo distinct polarization states (M1 and M2) that significantly influence sepsis outcomes. Nrf2 has been shown to play a protective role in sepsis-induced pulmonary injury and inflammation by modulating autophagy and NF-κB/PPARγ-mediated macrophage polarization 21. Similarly, Krüppel-like transcription factors reduce macrophage glycolysis and inflammatory cytokine secretion by suppressing the M1 macrophage polarized phenotype 22. Our recent work revealed that Blimp-1 inhibits the secretion of inflammatory cytokines via multiple toll-like receptors 12, which elucidate a novel role for Blimp-1 in macrophage polarization during sepsis.
Macrophage metabolic remodeling is essential for adapting to different polarized states and their functional changes 13, 14, 15, 17. The polarization of M2 macrophages involves alterations in several metabolic pathways, including glucose, amino acid, fatty acid, and nucleotide metabolism. Specifically, in fatty acid metabolism, PGC-1β collaborates with PPARγ to inhibit the secretion of inflammatory factors in M1 macrophages and to promote the M2 polarization 23. The mechanism may involve PPARγ and PGC-1β directly regulating ARG1 expression, with their activation playing a crucial role in mitochondrial respiration and fatty acid oxidation in M2 macrophages 15, 16.
In glucose metabolism, TKT, a key enzyme in the pentose phosphate pathway downstream of D-fructose-1.6 diphosphate, is upregulated in M1 macrophages along with glycolysis-related enzymes; however, this does not affect PPAT-related purine synthesis or cell proliferation 24. In amino acid metabolism, GATM and GPT2, which are involved in the glutamate pathway, facilitate glutaminolysis, leading to α-ketoglutarate accumulation and M2 polarization 25, 26. In our study, Blimp-1 suppression led to a significant reduction in the mRNA expression of Pparg, Ppargc1b, Tkt, Gatm, and Gpt2 in M2 macrophages, while Blimp-1 overexpression resulted in a marked increase in these genes. These findings suggest that Blimp-1 regulates M2 macrophage polarization by modulating key metabolic enzyme expressions.
Enhanced glycolysis during M2 macrophage polarization provides a metabolic basis for improved mitochondrial oxidative phosphorylation. M2 macrophages sustain their metabolism primarily through the tricarboxylic acid cycle and mitochondrial oxidative phosphorylation, resulting a more robust oxidative metabolic profile compared to M1 macrophages 27. Our results demonstrated that Blimp-1 knockdown led to substantial inhibition of both basal respiration and maximum respiratory capacity in mitochondrial oxidative phosphorylation, as well as glycolytic function. These results confirm that Blimp-1 regulates both mitochondrial oxidative phosphorylation and glycolysis in macrophages.
Our results claimed that Blimp-1 enhances the transcription of PPAT, ASS1, and ASL, affecting purine biosynthesis and the Ornithine cycle in M2 macrophages. Previous studies have linked the Ornithine cycle with M2 polarization 14. Notably, the expression of ARG1, a marker of M2 macrophages, is associated with the Ornithine cycle, while citrulline consumption is indicative of M1 polarization 28. Although research on purine biosynthesis regulation in macrophage polarization is limited, both purine metabolism and the Ornithine cycle depend on glutamine, a star amino acid that regulates macrophage function 26, 29. Glutamine contributes α-ketoglutaric acid to the tricarboxylic acid cycle and facilitates acetylation modification of histones through acetyl-CoA, activating α-ketoglutaric acid-dependent epigenetic regulation and thereby influencing M2 macrophage polarization 30. Actually, glutamine is the hub of purine biosynthesis and Ornithine cycle, connecting the metabolism of two kinds of biological macromolecules. Our study not only confirmed the regulatory mechanism of glutamine metabolism by Blimp-1, but also more comprehensively mapped the characteristics of glutamine-centered purine biosynthesis and Ornithine cycle metabolism in M2 macrophages. By elucidating the transcriptional regulation mechanism of Blimp-1 on various metabolic enzymes, this study revealed the metabolic regulation of M2 polarization and the pathological mechanism of sepsis progression.
While our study provides valuable insights into the role of Blimp-1 in sepsis pathogenesis, several limitations warrant consideration. First, the study predominantly utilized animal models, necessitating validation in human samples. Second, a mouse model of Blimp-1 conditional knockout in macrophages is needed to elucidate the exact mechanism of Blimp-1 for metabolic reprogramming, including detailed dynamics and interactions with other regulatory pathways. Third, due to the lack of suitable ChIP antibodies, the direct binding site and strength of Blimp-1 to target gene promoters cannot be evaluated in vivo. Additionally, longitudinal studies are needed to assess the long-term effects of Blimp-1 modulation on immune function and host recovery in sepsis.
In conclusion, our study unveils a novel regulatory role for Blimp-1 in macrophage polarization during sepsis, mediated through modulation of purine biosynthesis and the Ornithine cycle. These findings expand our understanding of the complex interplay between metabolism and immune responses in sepsis pathology.