Author: V. Dimov, M.D., Allergist/Immunologist and Assistant Professor at University of Chicago
Reviewer: S. Randhawa, M.D., Allergist/Immunologist and Assistant Professor at LSU (Shreveport) Department of Allergy and Immunology
Mononuclear phagocytes circulate in the blood as monocytes and reside in all tissues of the body as macrophages.
Macrophages differentiate into specialized forms in different tissues remembered by the mnemonic KOMA:
Kupffer cells (liver)
Alveolar macrophages (lung)
Monocytes turn into macrophages once they enter tissues. Dendritic cells are not the same as macrophages. Monoblasts give rise to both macrophages and dendritic cells.
Monocytes express CD14 and CD16. They migrate to peripheral tissues via VLA-4/VCAM-1 interactions. Monocytes express CD14, CD11b/CD18 (Mac-1), and CD36.
Monocytes are CD45+ CD14+ cells. Granulocytes are CD45+ CD15+ cells.
CD14 is present on macrophages. CD14 is the first described pattern recognition receptor (PAMP receptor) and it binds to bacterial LPS.
TLR4 (for LPS)
CD16 is FcγRIII, a low-affinity Fc receptor for IgG. CD16 is found on NK cells, macrophages, and neutrophils.
Fc gamma receptors for IgG are CD 16, 32, 64 (double). Fc gamma receptors for IgG (CD 16, 32, 64) are labeled in "reverse" order:
CD 16 - FcR III - low-affinity
CD 32 - FcR II - intermediate-affinity
CD 64 - FcR I - high-affinity
CD16 and CD56 are present on NK cells.
Fc II receptors:
CD 32 - Fc gamma II
CD 23 - Fc epsilon II, Fc receptors for IgE
Hemophagocytic lymphohistiocytosis (HLH)
Hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome is an uncontrolled activation of macrophages with increase in circulating cytokines. This potentially life-threatening disease is
characterized by fever, hepatosplenomegaly and high ferritin. Hemophagocytosis can often be seen on bone marrow
In boys with X-linked lymphoproliferative (XLP) syndrome (Duncan’s syndrome), HLH is often a fatal complication of Epstein-Barr virus (EBV) infection.
Interferon regulatory factor 8 (IRF8) Mutations and Human Dendritic-Cell Immunodeficiency. NEJM, 2011.