Heme and macrophages: a complicated liaison

In this issue of Blood, Sharma et al show that hepatic damage in sickle cell disease (SCD) is aggravated by the limited ability of phagocytes to clear apoptotic cells, a process known as efferocytosis, and to resolve inflammation.(1) Hemolysis plays a major role by reprogramming macrophages towards highly inflammatory and poorly efferocytic cells through the coordinated suppression of efferocytosis receptors and induction of a metabolic shift towards aerobic glycolysis.