Inflammatory Monocyte-Derived Macrophages Drive Pain via Their Production of Nerve Growth Factor after Peripheral...

Immune cells are vital to regeneration and repair processes in the nervous system. We previously reported that myeloid cells play a critical role in nerve regeneration and locomotor recovery after peripheral nerve injury (PNI) by facilitating the clearance of inhibitory myelin debris, promoting angiogenesis, and producing neurotrophins (NTs) such as nerve growth factor (NGF), brain-derived neurotrophic factor, NT-3, and NT-4/5. Here, we show that NTs are synthesized by various types of myeloid cells after PNI, including neutrophils, macrophages, and dendritic cells. Notably, we found that within the first week of PNI in male and female mice, monocyte-derived Cd11b⁺Cd68⁺Ly6B⁺Ly6C^hi macrophages infiltrate the sciatic nerve in an interleukin-1-dependent but CC chemokine receptor 2-independent manner and then locally produce mature NGF. Accordingly, depletion of circulating monocytes using PLX73086, a CSF1R inhibitor unable to cross blood-nervous system barriers, reduced NGF mRNA levels in the sciatic nerve distal stump. When polarized toward a proinflammatory phenotype in vitro, mouse macrophages rapidly release the cleaved form of NGF. Further analysis revealed that systemic administration of an anti-NGF-neutralizing antibody reduced mechanical pain in mice with PNI. Together with our previous work, these results suggest that infiltrating monocyte-derived macrophages release NGF, thereby promoting both peripheral nerve regeneration and pain following injury.