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Cardiac Immune Cell–Mediated Inflammatory Responses Exacerbate Myocardial Cell Injury in Mice
Daniel R. Whitfield, PhD1, Emily J. Morrison, PhD, Thomas L. Harrington, PhD, Sarah K. Donnelly, MD, PhD
*
1 Department of Cardiology and Molecular Medicine, Monash University, Melbourne, VIC, Australia
Article history: Received 30 August 2025 · Revised 12 September 2025 · Accepted 22 October 2025 · Published 09 November 2025
© 2025 Donnelly, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0).
Abstract
Background: Myocardial cell injury is a central event in the pathogenesis of acute and chronic cardiac diseases and is strongly influenced by inflammatory responses within the injured myocardium. Macrophages are among the earliest and most abundant immune cells recruited to the heart following injury; however, their precise contribution to cardiomyocyte damage remains incompletely defined.
Methods: Myocardial injury was induced in adult C57BL/6J mice, and inflammatory responses were assessed at defined time points. Macrophage infiltration and phenotype were evaluated using immunohistochemistry and flow cytometry. Systemic macrophage depletion was achieved using clodronate liposomes to determine the contribution of macrophages to myocardial injury. Cardiomyocyte injury and tissue damage were quantified histologically, and myocardial expression of pro-inflammatory cytokines was assessed by immunohistochemical analysis.
Results: Myocardial injury resulted in robust macrophage accumulation within the heart, with a predominance of inflammatory Ly6C^high macrophage subsets during the acute injury phase. Increased macrophage infiltration closely correlated with enhanced cardiomyocyte injury and elevated myocardial expression of TNF-α and IL-1β. Macrophage depletion significantly reduced cardiac macrophage numbers, attenuated pro-inflammatory cytokine expression, and led to a marked reduction in myocardial cell injury and tissue damage. These findings demonstrate a direct association between macrophage-driven inflammation and cardiomyocyte injury severity.
Conclusions: Macrophage-driven inflammatory responses play a critical role in amplifying myocardial cell injury in experimental mouse models. Targeted modulation of macrophage recruitment and inflammatory signaling may represent a promising therapeutic strategy to limit inflammation-induced myocardial damage and improve cardiac outcomes following injury.
Keywords: Myocardial cell injury; Cardiac inflammation; Macrophages; Macrophage polarization; Pro-inflammatory cytokines
- Libby P. Inflammation in atherosclerosis. Nature. 2002;420(6917):868-874. doi:10.1038/nature01323
- Frangogiannis NG. The inflammatory response in myocardial injury, repair, and remodelling. Nat Rev Cardiol. 2014;11(5):255-265. doi:10.1038/nrcardio.2014.28
- Swirski FK, Nahrendorf M. Leukocyte behavior in atherosclerosis, myocardial infarction, and heart failure. Science. 2013;339(6116):161-166. doi:10.1126/science.1230719
- Timmers L, et al. Toll-like receptor 4 mediates myocardial ischemia/reperfusion injury. Circulation. 2008;117(19):2583-2592. doi:10.1161/circulationaha.107.731364
- Chen GY, Nuñez G. Sterile inflammation: sensing and reacting to damage. Nat Rev Immunol. 2010;10(12):826-837. doi:10.1038/nri2873
- Epelman S, et al. Resident cardiac macrophages maintain homeostasis and protect the heart. Immunity. 2014;40(1):91-104. doi:10.1016/j.immuni.2013.11.019
- Nahrendorf M, Swirski FK. Monocyte and macrophage heterogeneity in the heart. Circ Res. 2013;112(12):1624-1633. doi:10.1161/CIRCRESAHA.113.300890
- Frantz S, et al. Innate immunity and myocardial ischemia/reperfusion injury. Cardiovasc Res. 2011;90(2):254-263. doi:10.1093/cvr/cvq366
- Ong SB, et al. Inflammation following acute myocardial infarction. Cardiovasc Res. 2018;114(1):16-28. doi:10.1093/cvr/cvx144
- Swirski FK, et al. Identification of splenic reservoir monocytes. Science. 2009;325(5940):612-616. doi:10.1126/science.1175202
- Ma Y, et al. Temporal dynamics of cardiac macrophage activation. J Mol Cell Cardiol. 2016;92:78-88. doi:10.1016/j.yjmcc.2016.01.006
- Lavine KJ, et al. Distinct macrophage lineages contribute to cardiac repair. J Exp Med. 2014;211(12):2317-2331. doi:10.1084/jem.20141028
- Dick SA, et al. Self-renewing resident cardiac macrophages limit adverse remodeling. Nat Immunol. 2019;20(1):29-39. doi:10.1038/s41590-018-0272-2
- Prabhu SD, Frangogiannis NG. The biological basis for cardiac repair after MI. Circ Res. 2016;119(1):91-112. doi:10.1161/CIRCRESAHA.116.303577
- Yan X, et al. Temporal dynamics of cardiac immune cell accumulation. Basic Res Cardiol. 2013;108(2):327. doi:10.1007/s00395-013-0327-9
- Sica A, Mantovani A. Macrophage plasticity and polarization. J Clin Invest. 2012;122(3):787-795. doi:10.1172/JCI59643
- Gordon S, Martinez FO. Alternative activation of macrophages. Immunity. 2010;32(5):593-604. doi:10.1016/j.immuni.2010.05.007
- Dewald O, et al. Monocyte chemoattractant protein-1 regulates infarct healing. Circ Res. 2005;96(8):881-889. doi:10.1161/01.RES.0000163017.13772.3b
- Westman PC, et al. Inflammation as a driver of adverse remodeling. J Am Coll Cardiol. 2016;67(17):2050-2060. doi:10.1016/j.jacc.2016.01.073
- Anzai A, et al. Regulatory role of reparative macrophages after MI. J Clin Invest. 2017;127(1):297-314. doi:10.1172/JCI87787
- Dinarello CA. Interleukin-1 in cardiovascular disease. Eur Heart J. 2010;31(23):2843-2851. doi:10.1093/eurheartj/ehq287
- Kleinbongard P, et al. Reactive oxygen species in ischemia/reperfusion injury. Cardiovasc Res. 2010;88(1):10-17. doi:10.1093/cvr/cvq207
- Hulsmans M, et al. Macrophage-derived exosomes in cardiac injury. Nat Rev Cardiol. 2018;15(6):327-340. doi:10.1038/s41569-018-0006-7
- Bang C, et al. Cardiac fibroblast–derived microRNA passenger strand. Nature. 2014;507(7490):364-368. doi:10.1038/nature13077
- King KR, et al. IRF3-driven inflammation worsens MI injury. Nat Med. 2017;23(1):78-86. doi:10.1038/nm.4258
- Ridker PM, et al. Antiinflammatory therapy with canakinumab. N Engl J Med. 2017;377(12):1119-1131. doi:10.1056/NEJMoa1707914
- Toldo S, Abbate A. The NLRP3 inflammasome in MI. Nat Rev Cardiol. 2018;15(4):203-214. doi:10.1038/nrcardio.2017.161
- Leuschner F, et al. Therapeutic silencing of CCR2. Nat Biotechnol. 2011;29(11):1005-1010. doi:10.1038/nbt.1982
- Panizzi P, et al. Imaging immune cell trafficking. Nat Med. 2010;16(10):1148-1153. doi:10.1038/nm.2220
- Heidt T, et al. Chronic stress accelerates atherosclerosis. Nat Med. 2014;20(7):754-759. doi:10.1038/nm.3588
- Shiraishi M, et al. Alternatively activated macrophages in healing. Circ Res. 2016;119(3):353-367. doi:10.1161/CIRCRESAHA.116.308286
- Van der Laan AM, et al. Macrophage subsets in infarcted myocardium. Eur Heart J. 2014;35(7):451-463. doi:10.1093/eurheartj/eht381
- Ruparelia N, et al. Inflammatory processes in cardiovascular disease. Atherosclerosis. 2017;263:189-198. doi:10.1016/j.atherosclerosis.2017.05.017
- Kain V, et al. Macrophage-mediated inflammation in heart failure. J Mol Cell Cardiol. 2014;72:273-282. doi:10.1016/j.yjmcc.2014.03.012
- Hulsmans M, et al. Neutrophil–macrophage interactions in MI. Circ Res. 2017;120(5):810-825. doi:10.1161/CIRCRESAHA.116.309969
- Martinez FO, Gordon S. The M1 and M2 paradigm. F1000Prime Rep. 2014;6:13. doi:10.12703/P6-13
- Zhang Y, et al. Macrophage polarization in cardiac repair. Cell Mol Immunol. 2019;16(6):477-489. doi:10.1038/s41423-018-0028-x
- Ong SB, Hausenloy DJ. Mitochondrial dynamics in I/R injury. Cardiovasc Res. 2010;88(1):16-29. doi:10.1093/cvr/cvq213
- Li Y, et al. Crosstalk between macrophages and cardiomyocytes. J Cell Mol Med. 2018;22(10):4794-4805. doi:10.1111/jcmm.13738
- Pinto AR, et al. Revisiting cardiac cellular composition. Circ Res. 2016;118(3):400-409. doi:10.1161/CIRCRESAHA.115.307778
- Hoyer FF, Nahrendorf M. Innate immune mechanisms in cardiac injury. J Mol Cell Cardiol. 2017;107:55-64. doi:10.1016/j.yjmcc.2017.03.007
- Epelman S, et al. Macrophages in the heart. Nat Rev Immunol. 2015;15(2):117-127. doi:10.1038/nri3800
- Ma Y, et al. Macrophage phenotypes in infarct healing. Am J Physiol Heart Circ Physiol. 2017;312(5):H1034-H1046. doi:10.1152/ajpheart.00686.2016
- van der Bijl P, et al. Inflammation and adverse remodeling. Heart. 2020;106(3):170-176. doi:10.1136/heartjnl-2019-315437
- Troidl C, et al. Monocyte subsets in cardiac repair. Cardiovasc Res. 2009;84(1):25-34. doi:10.1093/cvr/cvp170
- Mann DL. Innate immunity and the failing heart. Circ Res. 2015;116(7):1254-1268. doi:10.1161/CIRCRESAHA.116.302317
- Ridker PM. Inflammation and cardiovascular disease. J Am Coll Cardiol. 2019;74(17):2129-2138. doi:10.1016/j.jacc.2019.08.1018
- Prabhu SD. Cytokine-induced modulation of cardiac function. Circ Res. 2004;95(12):1140-1153. doi:10.1161/01.RES.0000150734.78944.0d

Pathophysiology of Cell Injury Journal (PCIJ)
E-ISSN 2378-5225 · Biannual
BM-Publisher (London, UK)
Open Access
Vol 14, Issue 2 (November 2025), pp. 140–162
How to cite (AMA)
Whitfield DR, Morrison MJ, Harrington TL, Donnelly SK. Cardiac Immune Cell–Mediated Inflammatory Responses Exacerbate Myocardial Cell Injury in Mice. Pathophysiology of Cell Injury Journal (PCIJ). 2025;14(2):140–162. doi: 10.18081/2378-5225/14.140.
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