Versatile immune cells found throughout the body that engulf pathogens and dead cells, coordinate inflammatory responses, and produce cytokines including TNF-α and IL-6. They are key targets of the vagus nerve's cholinergic anti-inflammatory pathway.
Macrophages are among the most important cell types in the immune system, functioning as both first responders and long-term tissue sentinels. They monitor tissues for infection, damage, and abnormality — and when they detect a threat, they release inflammatory mediators including TNF-α, IL-1β, IL-6, and HMGB1, which recruit other immune cells and initiate a broader response.
Macrophages are central to the cholinergic anti-inflammatory pathway. When the vagus nerve releases acetylcholine near macrophages in the spleen and other organs, the acetylcholine binds to α7 nicotinic acetylcholine receptors on the macrophage surface. This binding inhibits the cell's production of pro-inflammatory cytokines — effectively dampening the inflammatory response without suppressing the whole immune system.
Macrophages also play key roles in inflammation resolution and tissue repair. They can exist in a spectrum of activation states — broadly categorized as pro-inflammatory (M1) and anti-inflammatory/regulatory (M2) — and can shift between states depending on their environment.