THP-1-derived polarized macrophages differ by drug transporter transcriptomics, P-glycoprotein activity and

Katharina Hamburg1, Cindy Bay1, Jürgen Burhenne1

  • 1Internal Medicine IX - Department of Clinical Pharmacology and Pharmacoepidemiology Medical Faculty Heidelberg, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.

Archives of Toxicology
|January 9, 2026
PubMed

Insights

Tuberculosis drug efficacy is reduced in M2 macrophages due to higher P-glycoprotein (P-gp) activity, which limits rifampicin uptake. This study investigated drug transporter changes in M1 versus M2 macrophages.

Area of Science:

  • Pharmacology
  • Immunology
  • Cell Biology

Background:

  • Antibiotic efficacy in tuberculosis (TB) granulomas, particularly those rich in M2 macrophages, is often suboptimal.
  • This may stem from reduced drug penetration into M2 macrophages, potentially influenced by drug transporter activity, such as P-glycoprotein (P-gp).

Purpose of the Study:

  • To investigate the impact of macrophage polarization (M1 vs. M2) on drug transporter expression and activity.
  • To determine how these changes affect the cellular uptake of rifampicin, a key anti-TB drug.

Main Methods:

  • THP-1 cells were differentiated and polarized into M1 or M2 macrophages.
  • Quantitative polymerase-chain reaction arrays, flow cytometry, and ultra-performance liquid chromatography-tandem mass spectrometry were employed.
  • Evaluated expression of 84 drug transporter genes, P-gp efflux activity, and rifampicin cellular uptake kinetics.

Main Results:

  • ABCB1 (encoding P-gp) expression significantly increased during both M1 (166-fold) and M2 (55-fold) polarization.
  • M2 macrophages exhibited 1.55-fold higher P-gp efflux activity compared to M1 macrophages.
  • Rifampicin uptake was significantly lower in M2 macrophages than in M1 macrophages after 2h or 4h exposure.

Conclusions:

  • M2 macrophages display a distinct drug transporter profile compared to M1 macrophages.
  • Enhanced P-gp expression and activity in M2 macrophages contribute to reduced rifampicin uptake.
  • These findings highlight potential mechanisms underlying the inferior efficacy of antibiotics in M2 macrophage-dominant TB granulomas.