TGF-β promotes glycolysis through PFKL in activated macrophages and exacerbates sepsis by disrupting blood coagulation

Abstract The metabolism of macrophages plays a key role in their immune responses, but the mechanisms by which the metabolism is regulated remain largely unknown. We show here that TGF-β induces a unique phenotype of macrophages and regulates the glycolysis of macrophages independently of inflammatory cytokine production. Specifically, TGF-β increased expression and activity of phosphofructokinase-1 liver type (PFKL) in macrophages and thus promoted their glycolysis during cell activation, yet paradoxically suppressed the production of proinflammatory cytokines in the same macrophages. The upregulation of glycolysis was mediated by an mTORc-MYC dependent pathway, whereas the inhibition of cytokines was ascribed to downregulated activation of the major pro-inflammatory transcription factors, namely AP-1, NFkB and STAT1. Importantly, we found that in LPS-induced sepsis model, TGF-β enhancement of macrophage glycolysis led to a decreased survival in mice by increasing blood coagulation. Analysis of cohorts of patients with sepsis and covid-19 revealed that the expression of PFKL, TGF-b receptors TGFBRI and coagulation factor F13A1 in monocytes positively correlated with the progression of the disease. Thus, TGF-β is emerging as a critical cytokine regulating macrophage metabolism and could serve as a therapeutic target in patients with sepsis and Covid-19. Supporte by NIH/NIDCR intramural funding