Hematoma Resolution In Vivo Is Directed by Activating Transcription Factor 1.

Abstract

The efficient resolution of tissue hemorrhage is an important homeostatic function. In human macrophages in vitro, heme activates an AMPK (AMP-activated protein kinase)/ATF1 (activating transcription factor-1) pathway that directs Mhem macrophages through coregulation of HO-1 (heme oxygenase-1; <i>HMOX1</i>) and lipid homeostasis genes. We asked whether this pathway had an in vivo role in mice. Perifemoral hematomas were used as a model of hematoma resolution. In mouse bone marrow-derived macrophages, heme induced HO-1, lipid regulatory genes including LXR (lipid X receptor), the growth factor IGF1 (insulin-like growth factor-1), and the splenic red pulp macrophage gene <i>Spic</i>. This response was lost in bone marrow-derived macrophages from mice deficient in AMPK (<i>Prkab1</i>^-/^-) or ATF1 (<i>Atf1</i>^-/-). In vivo, femoral hematomas resolved completely between days 8 and 9 in littermate control mice (n=12), but were still present at day 9 in mice deficient in either AMPK (<i>Prkab1</i>^-/-) or ATF1 (<i>Atf1</i>^-/-; n=6 each). Residual hematomas were accompanied by increased macrophage infiltration, inflammatory activation and oxidative stress. We also found that fluorescent lipids and a fluorescent iron-analog were trafficked to lipid-laden and iron-laden macrophages respectively. Moreover erythrocyte iron and lipid abnormally colocalized in the same macrophages in <i>Atf1</i>^-/- mice. Therefore, iron-lipid separation was <i>Atf1</i>-dependent. Taken together, these data demonstrate that both AMPK and ATF1 are required for normal hematoma resolution. Graphic Abstract: An online graphic abstract is available for this article.