title: CD206-positive M2 macrophages that express heme oxygenase-1 protect against diabetic gastroparesis in mice.
abstract: OBJECTIVE
  Gastroparesis is a well-recognized complication of diabetes. In diabetics, up-regulation of heme oxygenase-1 (HO1) in gastric macrophages protects against oxidative stress-induced damage. Loss of up-regulation of HO1, the subsequent increase in oxidative stress, and loss of Kit delays gastric emptying; this effect is reversed by induction of HO1. Macrophages have pro- and anti-inflammatory activities, depending on their phenotype. We investigated the number and phenotype of gastric macrophages in NOD/ShiLtJ (nonobese diabetic [NOD]) mice after onset of diabetes, when delayed gastric emptying develops, and after induction of HO1 to reverse delay.
  
  
  METHODS
  Four groups of NOD and db/db mice were studied: nondiabetic, diabetic with normal emptying, diabetic with delayed gastric emptying, and diabetic with delayed gastric emptying reversed by the HO1 inducer hemin. Whole mount samples from stomach were labeled in triplicate with antisera against F4/80, HO1, and CD206, and macrophages were quantified in stacked confocal images. Markers for macrophage subtypes were measured by quantitative polymerase chain reaction.
  
  
  RESULTS
  Development of diabetes was associated with an increased number of macrophages and up-regulation of HO1 in CD206(+) M2 macrophages. Onset of delayed gastric emptying did not alter the total number of macrophages, but there was a selective loss of CD206(+)/HO1(+) M2 macrophages. Normalization of gastric emptying was associated with repopulation of CD206(+)/HO1(+) M2 macrophages.
  
  
  CONCLUSIONS
  CD206(+) M2 macrophages that express HO1 appear to be required for prevention of diabetes-induced delayed gastric emptying. Induction of HO1 in macrophages might be a therapeutic option for patients with diabetic gastroparesis.
authors.affiliation: Enteric Neuroscience Program and Department of Physiology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Kyoung Moo
authors.initials: KM
authors.lastname: Choi
authors.forename: Purna C
authors.initials: PC
authors.lastname: Kashyap
authors.forename: Nirjhar
authors.initials: N
authors.lastname: Dutta
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Stoltz
authors.forename: Tamas
authors.initials: T
authors.lastname: Ordog
authors.forename: Terez
authors.initials: T
authors.lastname: Shea Donohue
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Bauer
authors.forename: David R
authors.initials: DR
authors.lastname: Linden
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Szurszewski
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Gibbons
authors.forename: Gianrico
authors.initials: G
authors.lastname: Farrugia
mesh_terms: D000818:Animals; D001119:Arginase / Q000235:genetics; D001786:Blood Glucose / Q000032:analysis; D048909:Diabetes Complications / Q000517:prevention & control*; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000517:prevention & control*; D051547:Heme Oxygenase-1 / Q000032:analysis / Q000502:physiology*; D016753:Interleukin-10 / Q000235:genetics; D037181:Lectins, C-Type / Q000032:analysis*; D008264:Macrophages / Q000201:enzymology / Q000502:physiology*; D000090323:Mannose Receptor; D037241:Mannose-Binding Lectins / Q000032:analysis*; D008565:Membrane Proteins / Q000032:analysis / Q000502:physiology*; D051379:Mice; D016688:Mice, Inbred NOD; D011956:Receptors, Cell Surface / Q000032:analysis*
chemical_list: D001786:Blood Glucose; D037181:Lectins, C-Type; D000090323:Mannose Receptor; D037241:Mannose-Binding Lectins; D008565:Membrane Proteins; D011956:Receptors, Cell Surface; D016753:Interleukin-10; D051547:Heme Oxygenase-1; C496542:Hmox1 protein, mouse; C544448:Arg1 protein, mouse; D001119:Arginase