Macrophages: Balancing Inflammation and Homeostasis in Health and Disease

Inflammation is crucial for maintaining tissue homeostasis and responding to insults, yet dysregulated inflammation can lead to various diseases. Macrophages, central to the immune system, play key roles in initiating, regulating, and resolving inflammation. This review provides an overview of macrophage functions, including activation mechanisms, recruitment to inflamed tissues, interactions with other immune cells and mediators, and their roles in phagocytosis, clearance of apoptotic cells and debris, and secretion of anti-inflammatory cytokines. Additionally, it discusses macrophage-induced regulatory T-cell formation, the impact of pro-inflammatory and anti-inflammatory cytokines on macrophage behavior, and the influence of microbial products and pathogen-associated molecular patterns (PAMPs) on macrophage function. The review also identifies targeting macrophages as a promising strategy for managing inflammatory diseases while acknowledging challenges such as macrophage heterogeneity, limitations of in vitro models, and incomplete understanding of regulatory mechanisms. Finally, it suggests areas for further research, including identifying specific macrophage subsets, understanding macrophage plasticity, exploring resolution signaling pathways, and investigating the role of metabolism and microenvironmental cues in macrophage function, aiming to pave the way for more effective macrophage-targeted therapies in inflammatory diseases.