Platelet-macrophage cooperation drives IL-33-dependent type 2 lung immunopathology in a sex-biased manner.

Hayashi, H., Nagai, J., Lai, J., Zaleski, K., Feng, C., Hastings, M., Nishida, A., Tani, Y., Lin, J., Sasaki, M., Alhallak, K., Marshall, S. A., Liu, T., Balestrieri, B., & Boyce, J. A. (2026). Platelet-macrophage cooperation drives IL-33-dependent type 2 lung immunopathology in a sex-biased manner.. The Journal of Allergy and Clinical Immunology.

Abstract

BACKGROUND: Platelets amplify lung type 2 inflammation (T2I), but the underlying mechanisms remain incompletely understood.

OBJECTIVE: We elucidated the platelet-driven T2I mechanisms, particularly the role of platelet-derived leukotriene C4 (LTC4).

METHODS: We assessed lung T2I to Alternaria alternata extract in vivo using mice with targeted deletions of Ltc4s in platelets, macrophages (Macs), or mast cells (MCs); Il33 in Macs, hematopoietic cells, or alveolar type 2 (AT2) cells; and cysteinyl leukotriene receptors. Exogenous administration of LTC4 and IL-33 in naïve mice complemented the genetic models. Sex- and age-matched mice were randomly assigned, and histopathologic evaluations were performed under blinded conditions.

RESULTS: Platelets promoted IL-33 expression in perivascular Macs and induced transcellular LTC4 synthesis. Although platelet Ltc4s was not needed to induce IL-33+ Macs, it promoted both IL-33+ AT2 cell and group 2 innate lymphoid cell expansions in a sex-biased manner. Platelet depletion abrogated A alternata-induced increases in IL-33 and AT2 cell expansion. Platelet-adherent Macs expressed higher IL-33 than no-adherent counterparts. Platelet-specific Ltc4s deletion reduced eosinophil, group 2 innate lymphoid cell, and AT2 cell expansion in female animals in a delayed manner. Mac-specific Il33 deletion eliminated platelet-driven IL-33 increases and attenuated AT2 cell expansion selectively in female animals. Exogenous LTC4 and IL-33 synergistically induced IL-33+ Macs and expanded AT2 cells.

CONCLUSION: Adherent platelets rapidly upregulate IL-33-expressing Macs, and platelet-derived LTC4 sustains IL-33-driven expansion of AT2 cells and group 2 innate lymphoid cells, driving sex-biased amplification of T2I. This platelet-Mac axis may contribute to sex differences in type 2 inflammatory airway diseases such as asthma.

Last updated on 04/01/2026
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