Macrophage polarization in the maculae of age-related macular degeneration: A pilot study

Xiaoguang Cao, Defen Shen, Mrinali M. Patel, Jingsheng Tuo, T. Mark Johnson, Timothy W. Olsen, Chi Chao Chan

Research output: Contribution to journalArticlepeer-review

134 Scopus citations


Macrophages can be polarized to exhibit either pro-inflammatory M1 or pro-angiogenic M2 phenotypes, but have high phenotypic plasticity. This pilot study investigated macrophage polarization in the macular retina and choroid of age-related macular degeneration (AMD) and non-AMD subjects, as well as in AMD choroidal neovascular membranes (CNVM). All specimens were evaluated for routine histopathology. Quantitative real-time polymerase chain reaction for representative M1 (CXCL11) and M2 (CCL22) transcripts were performed on macular choroidal trephines (MCT) of 19 AMD and nine non-AMD eye bank eyes, on the microdissected macular retinal cells from the archived slides of five geographic atrophic AMD, five exudative/neovascular AMD, and eight normal autopsied eyes, and on microdissected inflammatory cells from two surgically removed CNVM that did not respond to anti-vascular endothelial growth factor (VEGF) therapy. High M2-chemokine transcript and a low ratio of M1 to M2 chemokine transcript were found in aging non-AMD MCT. Advanced AMD maculae had a higher M1 to M2 chemokine transcript ratio compared to normal autopsied eyes. Macrophages in the two CNVM of patients unresponsive to anti-VEGF therapy were polarized toward either M1 or M2 phenotypes. The number of M2 macrophages was increased compared to M1 macrophages in normal aging eyes. A pathological shift of macrophage polarization may play a potential role in AMD pathogenesis.

Original languageEnglish (US)
Pages (from-to)528-535
Number of pages8
JournalPathology International
Issue number9
StatePublished - Sep 2011


  • Age-related macular degeneration (AMD)
  • Chemokine
  • Choroidal neovascularization
  • M1 macrophage
  • M2 macrophage

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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