Macrophage glycolysis interactions modulate inflammation and polarization in sepsis

This systematic review investigated the mechanisms underlying the interaction between inflammation and macrophage glycolysis specifically within the context of sepsis. The analysis centered on macrophages as the primary biological unit, with no specific patient population, sample size, or clinical setting reported. The review sought to elucidate how metabolic shifts in these cells influence inflammatory responses during sepsis.

The primary finding described a bidirectional relationship between metabolic activity and immune polarization. Increasing aerobic glycolysis was associated with the promotion of M1 macrophage polarization, a state that facilitates inflammation. Conversely, decreasing aerobic glycolysis was linked to M2 polarization, which was associated with alleviated inflammation. Additionally, the presence of inflammation in sepsis was noted to reciprocally affect glycolytic pathways within these cells.

No data regarding adverse events, serious adverse events, discontinuations, or overall tolerability were reported, as the evidence pertained to cellular mechanisms rather than clinical interventions. Consequently, safety profiles could not be assessed. The review did not report specific limitations beyond the inherent constraints of studying cellular models, nor were funding sources or conflicts of interest disclosed.

Given that the evidence is observational at the cellular level and lacks clinical trial data, the practice relevance for treating sepsis patients is currently unclear. Clinicians should interpret these mechanistic findings as foundational biological insights rather than direct evidence for therapeutic strategies. Further research is needed to translate these macrophage-specific observations into actionable clinical guidelines for sepsis management.