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Impaired efferocytosis by monocytes and monocyte-derived macrophages in patients with poorly controlled type 2

Qian-Yun Mao1, Hui Ran1, Qiu-Yue Hu1

  • 1Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.

World Journal of Diabetes
|June 9, 2025
PubMed
Abstract

Insights

Impaired efferocytosis, the clearance of apoptotic cells, is evident in type 2 diabetes (T2D) patients. Poor glycemic control negatively impacts this crucial immune function in both monocytes and macrophages.

Area of Science:

  • Immunology
  • Metabolic Diseases
  • Cell Biology

Background:

  • Deficient efferocytosis (phagocytic clearance of apoptotic cells) is a known issue in experimental type 2 diabetes (T2D).
  • Translating these findings to human patients is crucial for understanding T2D pathophysiology.

Purpose of the Study:

  • To investigate whether efferocytosis capacity is impaired in blood monocytes and monocyte-derived macrophages of T2D patients.
  • To correlate efferocytosis capacity with glycemic control and CD14 expression.

Main Methods:

  • Assessed efferocytosis in 30 T2D patients and 30 controls using flow cytometry and immunostaining.
  • Measured CD14 expression on macrophages and assessed metabolic/immune factors.
  • Utilized multivariate linear regression to analyze associations.

Main Results:

  • T2D patients exhibited significantly lower monocyte and macrophage efferocytosis indices compared to controls.
  • Efferocytosis remained impaired in macrophages derived from T2D monocytes.
  • Monocyte efferocytosis index correlated with HbA1c, and macrophage efferocytosis index correlated with CD14+ macrophage percentage.

Conclusions:

  • Type 2 diabetes impairs efferocytosis in both monocytes and macrophages.
  • Poor glycemic control (high HbA1c) is linked to reduced efferocytosis.
  • Glucotoxicity may reduce efferocytosis by decreasing CD14 expression.
Keywords:
EfferocytosisMacrophageMonocyteType 2 diabetes

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