Severely impaired pulmonary microbial clearance was observed in granulocytemacrophage colony-stimulating factor (GM-CSF)-deficient mice. To determine mechanisms by which GM-CSF mediates lung host defense, FcyR-mediated phagocytosis (opsonophagocytosis) by alveolar macrophages (AMs) was assessed in GM-CSF-sufficient (GM(+/+)) and -deficient (GM(-/-)) mice and in GM(-/-) mice expressing GM-CSF only in the lungs from a surfactant protein C (SPC) promoter (SPC-GM(+/+/)GM(-/-)). Opsonophagocytosis by GM-/- AMs was severely impaired and was restored by pulmonary GM-CSF expression in vivo or by PU.1 expression in vitro. Defective opsonophagocytosis by GM(-/-) AMs was associated with decreased FcgammaR expression. Because interferon-gamma (IFN-gamma) augments macrophage FcgammaR levels, the role of GM-CSF/PU.1 in the regulation of AM FcgammaR expression by IFN-gamma was assessed during adenoviral lung infection. Adenoviral infection stimulated IFN-gamma production and augmented FcgammaR levels on AMs in GM-CSF-expressing but not GM(-/-) mice. However, IFN-gamma exposure ex vivo stimulated FcyR expression on GM(-/-) AMs. Because interleukin-18 (IL-18) and IL-12 stimulate IFN-gamma production during adenoviral infection, their role in GM-CSF/PU.1 regulation of IFN-gamma-augmented FcgammaR expression on AMs was assessed. Adenoviral infection stimulated IL-18 and IL-12 production in GM-CSF-expressing mice, but both were markedly reduced or absent in GM(-/-). IL-18 expression by GM(-/-) AMs was severely impaired and was restored by pulmonary GM-CSF expression in vivo or by PU.1 expression in vitro. Pulmonary administration of IL-18 in GM-/- mice stimulated IFN-gamma production and restored FcgammaR expression on AMs. These results show that GM-CSF, via PU.1, regulates constitutive AM FcgammaR expression and opsonophagocytosis and is required for the IFN-gamma-dependent regulation of AM FcgammaR expression, enabling AMs to release IL-18/ IL-12 during lung infection. (Blood. 2002; 100:4193-4200) (C) 2002 by The American Society of Hematology.