Macrophage polarization: the link between inflammation and related diseases

In the present review, we try to critically evaluate the two faces of the macrophages and their roles in relation to gene alteration in some inflammatory conditions. The pros- and cons of each type of macrophage in immunologic outcomes are discussed. If "Diversity is the rule of nature", macrophages have proven to be its obedient followers. A cell type that was classically considered to be activated by Interferon-gamma, under the influence of T-H-1 type of response and a well-accepted warrior of cellular immunity to the intracellular pathogens is not as simple as once considered. Past decade has revolutionized this notion with the advent of T-H-2 influenced alternatively activated macrophages, now established as wound repairing and tissue regenerating. Literature survey was done to present a detailed study on this macrophage dichotomy and its relevance to immune disorders via expression of some critical genes, nuclear factor kappa-light-chain-enhancer of activated B cells, peroxisome proliferator-activated receptors and SH2-containing inositol-5'-phosphatase 1, highly implicated in a myriad of immunological emergencies like inflammation, insulin resistance, wound healing, cancer, etc. The evaluation of macrophage dichotomy in these disorders may prove to be the first step towards the formulation of innovative therapeutic approaches.