Role of Macrophages in Cardiac Remodeling: Cues From Zebrafish Heart.

BACKGROUND: Macrophages are a key component of innate immunity and regulate cardiac phenotypes by their polarization state. The classical M1 macrophages are activated by pro-inflammatory stimuli, whereas M2 macrophages are activated by anti-inflammatory stimuli. The balance between M1 and M2 polarization is important and tightly controlled to maintain tissue homeostasis. OBJECTIVE: This review aims to explain the diversity of the ability to regenerate among humans and zebrafish, the role of the immune system in heart regeneration, and macrophage function in normal conditions and disease. It also investigates age-related effects on macrophage function and therapeutic strategies to manipulate macrophage polarization in the treatment of heart injury. METHODS: Systematic review of the literature was conducted focusing on macrophage polarization, cardiac regeneration mechanisms, and immunomodulatory therapy. RESULTS: Macrophage polarization imbalances of M1-M2 are involved in inflammatory and cardiac disease. Mechanisms of macrophage function under various states and in various species are useful for insightful comprehension of novel therapy strategies. Macrophage polarization modulation is a future potential strategy for cardiac repair and the treatment of cardiac disease. CONCLUSION: Targeting macrophage polarization to restore balance and homeostasis is a promising strategy for supporting cardiac regeneration and the treatment of inflammatory cardiac disease.