Macrophages, Metabolism and Heterophagy in the Heart

José A. Nicolás-Ávila, Laura Pena-Couso, Pura Muñoz-Cánoves, Andrés Hidalgo

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations


The heart is a never-stopping engine that relies on a formidable pool of mitochondria to generate energy and propel pumping. Because dying cardiomyocytes cannot be replaced, this high metabolic rate creates the challenge of preserving organelle fitness and cell function for life. Here, we provide an immunologist's perspective on how the heart solves this challenge, which is in part by incorporating macrophages as an integral component of the myocardium. Cardiac macrophages surround cardiomyocytes and capture dysfunctional mitochondria that these cells eject to the milieu, effectively establishing a client cell-support cell interaction. We refer to this heterologous partnership as heterophagy. Notably, this process shares analogies with other biological systems, is essential for proteostasis and metabolic fitness of cardiomyocytes, and unveils a remarkable degree of dependence of the healthy heart on immune cells for everyday function.

Original languageEnglish
Pages (from-to)418-431
Number of pages14
JournalCirculation Research
Issue number3
StatePublished - 4 Feb 2022
Externally publishedYes


  • exopher
  • heart
  • heterophagy
  • macrophages
  • myocardium


Dive into the research topics of 'Macrophages, Metabolism and Heterophagy in the Heart'. Together they form a unique fingerprint.

Cite this