T‐Cell Immunoglobulin and Mucin Domain‐Containing Protein‐4 Is Critical for Kupffer Cell Homeostatic Function in the Activation and Resolution of Liver Ischemia Reperfusion Injury

Background and Aims Liver ischemia reperfusion injury (IRI) remains an unresolved clinical problem. This study dissected roles of liver‐resident macrophage Kupffer cells (KCs), with a functional focus on efferocytosis receptor T‐cell immunoglobulin and mucin domain‐containing protein‐4 (TIM‐4), in both the activation and resolution of IRI in a murine liver partial warm ischemia model. Approach and Results Fluorescence‐activated cell sorting results showed that TIM‐4 was expressed exclusively by KCs, but not infiltrating macrophages (iMФs), in IR livers. Anti‐TIM‐4 antibody depleted TIM‐4 + macrophages in vivo , resulting in either alleviation or deterioration of liver IRI, which was determined by the repopulation kinetics of the KC niche with CD11b + macrophages. To determine the KC‐specific function of TIM‐4, we reconstituted clodronate‐liposome–treated mice with exogenous wild‐type or TIM‐4‐deficient KCs at either 0 hour or 24 hours postreperfusion. TIM‐4 deficiency in KCs resulted in not only increases in the severity of liver IRI (at 6 hours postreperfusion), but also impairment of the inflammation resolution (at 7 days postreperfusion). In vitro analysis revealed that TIM‐4 promoted KC efferocytosis to regulate their Toll‐like receptor response by up‐regulating IL‐10 and down‐regulating TNF‐α productions. Conclusions TIM‐4 is critical for KC homeostatic function in both the activation and resolution of liver IRI by efferocytosis.