Host-derived lipids from tuberculous pleurisy impair macrophage microbicidal-associated metabolic activity

Mycobacterium tuberculosis (Mtb) regulates the macrophage metabolic state to thrive in the host, yet the responsible mechanisms remain elusive, Macrophage activation toward the microbicidal (M1) program depends on the HIF-1 alpha-mediated metabolic shift from oxidative phosphorylation (OXPHOS) toward glycolysis. Here, we ask whether a tuberculosis (TB) microenvironment changes the M1 macrophage metabolic state. We expose M1 macrophages to the acellular fraction of tuberculous pleural effusions (TB-PEs) and find lower glycolytic activity, accompanied by elevated levels of OXPHOS and bacillary load, compared to controls. The eicosanoid fraction of TB-PE drives these metabolic alterations. HIF-1 alpha stabilization reverts the effect of TBPE by restoring M1 metabolism. Furthermore, Mtb-infected mice with stabilized HIF-1 alpha display lower bacillary loads and a pronounced M1-like metabolic profile in alveolar macrophages (AMs). Collectively, we demonstrate that lipids from a TB-associated microenvironment alter the M1 macrophage metabolic reprogramming by hampering HIF-1 alpha functions, thereby impairing control of Mtb infection.