Table 1. Summary of the regenerative capacity, mechanisms, and disease states of representative mammalian tissues.
The process of regeneration is summarized for six different tissues, each with varying regenerative capacities: skin, heart, skeletal muscle, CNS, liver and bone. For each, steps that have the potential to be influenced by immunity are listed as well as the disease state and summary of immune targeted therapeutics.
| TISSUE | DEBRIS CLEARNACE MECHANISM |
PROGENITOR CELL POOL |
IMMUNE-DERIVED STIMULI |
POLARIZATION & HETEROGENITY |
DISEASE STATE DUE TO FAILED REGENERATION |
DEFECT | DRUGS TARGETING IMMUNITY |
|---|---|---|---|---|---|---|---|
| Skin (dermis) | Macrophages, fibroblasts, keratinocytes | Fibroblasts, endothelial cells | TGFβ, EGF, VEGF, IGF | Early and late macrophages (similar to M1/M2) | Full-thickness wound scarring in adults | Excessive inflammation Decreased migration Collagen accumulation |
IFN-α, IFN-β, IFN-γ; steroids |
| Heart | M1 or Ly-6Chi monocytes/macrophages | Resident cardiomyocytes | n/a | Four pools of cardiac macrophages; sequential Ly6Chi, Ly6Clo | Myocardial infarction Heart failure | Lack of progenitors; Insufficient immune polarization | ACE inhibitors |
| Skeletal muscle | Macrophages and FAPs | Satellite cells | Treg amphiregulin, IL-6, IL-1β, TNFα, IGF1, TGFβ | Muscle Treg; M1/M2 | Muscular dystrophy | Myofiber defect; satellite cell exhaustion; chronic inflammation | Glucocorticoids |
| CNS (myelination) | Macrophages and microglia | Oligodendrocyte progenitor cells | IGF1 | M1/M2 | Multiple sclerosis | Impaired clearance of myelin debris | anti-GM-CSF; Pioglitazone (PPARg agonist); Glatiramer acetate |
| Liver | Kupffer cell and liver macrophages | Hepatocytes and Hepatic Progenitor Cells | Eosinophil IL-4; Kupffer IL-6, TNFα | Inflammatory and restorative macrophages; Th1, Th2, Th17 lymphocytes | Chronic liver disease (viral, toxic, autoimmune, metabolic) | Unresolved fibrosis | TLR4, CCR2 inhibitors; PPAR-α/β agonists |
| Bone | Osteoclast | Monocyte progenitor | Csf1 | n/a | Osteopetrosis or osteoperosis | Lack of or excessive bone resorption | IFN-γ1b, corticosteroid; RANKL inhibitor (mAb) |