Non-Invasive Differentiation of M1 and M2 Activation in Macrophages Using Hyperpolarized ¹³C MRS of Pyruvate and DHA at 1.47 Tesla.

In M1 macrophages, lactate levels follow an increasing trend ( p = 0.128), which is also in line with the HP results.

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Highly significant increases in itaconate and succinate concentrations are seen in M1 macrophages compared to control, in line with previous reports [ 39 ], as itaconate is a well-known product of M1 polarization [ 40 ] and a potent inhibitor of succinate dehydrogenase, which leads to succinate accumulation [ 41 ].

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In M2-activated macrophages, the HP 13 C lactate-to-pyruvate ratio was not significantly different from control, although a trend towards significance was observed.

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