Latest perspectives on macrophages in bone homeostasis

Knowledge about macrophages residing in the bone, also known as osteal macrophages or osteomacs, is still limited. A hallmark of this peculiar myeloid population is the expression of macrophage markers distinct from the markers found on osteoclast surface. In bone, osteomacs are in contact with osteoblasts, where they are involved in regulating bone homeostasis. However, additional macrophage subtypes already present in the bone marrow or recruited from the blood circulation could have further functions, which could be all important for the maintenance of the bone architecture and its associated functions. Indeed, bone marrow macrophages have been found to eliminate apoptotic cells, particularly apoptotic osteoblasts through a process named efferocytosis. This phagocytic process plays an essential role in bone tissue homeostasis and new bone formation. In addition, bone marrow macrophages can influence the hematopoietic stem cell (HSC) niches. They contribute to the regulation of the HSC progenitor cell maintenance, mobilization, and function. To do so, macrophages secrete cytokines in steady state or during stress conditions. These cytokines influence hematopoiesis either by a direct effect on HSCs or through the control of stromal cells that are essential for the HSC niches. Interestingly, the similarities between the niches for HSCs and the niche for metastatic tumor cells support the possibility that bone-resident macrophages could control the homing of tumor cells and their proliferation within the bone. In general, macrophage role during metastatic processes is well described; however, their direct involvement in bone metastasis is a rising research area. In this review, we will highlight the macrophage functions in the skeleton, in the maintenance of the HCS niches, and their importance in bone metastasis.