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Blood, 8 January 2009, Vol. 113, No. 2, pp. 438-446.
Prepublished online as a Blood First Edition Paper on October 24, 2008; DOI 10.1182/blood-2008-04-150789.


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PHAGOCYTES, GRANULOCYTES, AND MYELOPOIESIS

A functional folate receptor is induced during macrophage activation and can be used to target drugs to activated macrophages

Wei Xia*,1, Andrew R. Hilgenbrink*,1, Eric L. Matteson2, Michael B. Lockwood3, Ji-Xin Cheng1,4, and Philip S. Low1

1 Department of Chemistry, Purdue University, West Lafayette, IN; 2 Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN; 3 Department of Rheumatology, Clarian Arnett Health, Lafayette, IN; and 4 Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN

Previous work has demonstrated that a subset of macrophages expresses a folate receptor (FR) that can mediate internalization of folate-linked molecules, including imaging and therapeutic agents. To characterize this subset, macrophages were collected from peritoneal cavities of mice injected with saline, thioglycolate, zymosan, heat-killed or live bacteria, and cell-surface markers that coexpress with FR were identified. Virtually no F4/80+ peritoneal macrophages from saline-injected mice expressed FR, whereas numerous macrophages from mice injected with each inflammatory stimulus expressed FR. Examination of cell differentiation antigens that are up-regulated in FR+ macrophages revealed markers characteristic of an activated state (CD80, CD86, Ly-6C/G), whereas macrophages lacking these activation markers expressed few or no FR. FR+ macrophages also produced tumor necrosis factor-{alpha} (TNF-{alpha}) and reactive oxygen species, and production of reactive oxygen species correlated linearly with expression of FR. Synovial macrophages collected from arthritic patients were found to bind and internalize folate-linked dyes. Moreover, a folate-linked radioimaging agent was shown to image inflamed joints of rheumatoid arthritic patients. These results suggest that FR constitutes a marker for macrophage activation and that FR+ macrophages can be targeted with folate-linked drugs without promoting drug uptake by nonactivated macrophages. This trial was registered at www.clinicaltrials.gov as #NCT00588393 [ClinicalTrials.gov] .


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