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CCR2

CCR2, or C-C motif chemokine receptor 2 (also known as CD192), is a protein encoded by the CCR2 gene located on chromosome 3p21.31 in humans. It functions as a G protein-coupled receptor (GPCR) primarily binding the chemokine CCL2 (monocyte chemoattractant protein-1, or MCP-1) and other CC chemokines including CCL7, CCL8, CCL13, and CCL16, to mediate the chemotaxis and migration of immune cells such as monocytes, macrophages, immature dendritic cells, and subsets of T lymphocytes toward sites of inflammation or injury.^[1]^[2] Structurally, CCR2 belongs to the class A subfamily of GPCRs, characterized by seven transmembrane α-helices connected by three extracellular and three intracellular loops, along with two conserved disulfide bonds (between Cys32-Cys277 and Cys113-Cys190) that stabilize its conformation. Alternative splicing of the CCR2 gene produces two major isoforms, CCR2A and CCR2B, which share an identical extracellular domain but differ in their C-terminal tails, affecting downstream signaling, receptor internalization, and desensitization.^[3]^[1] Upon ligand binding, CCR2 activates heterotrimeric Gαi proteins, leading to inhibition of adenylyl cyclase, intracellular calcium mobilization, and activation of signaling cascades such as PI3K/AKT, MAPK/ERK, and NF-κB pathways, which collectively promote cell adhesion, migration, survival, and pro-inflammatory responses. Expressed predominantly on monocytes and macrophages, CCR2 orchestrates immune cell trafficking in various physiological and pathological contexts, including acute and chronic inflammation, atherosclerosis, rheumatoid arthritis, and multiple sclerosis.^[2]^[3] In disease, CCR2 contributes to pathology across multiple systems: in the central nervous system, it facilitates monocyte extravasation and microglial activation during neuroinflammation; in the liver, it drives fibrosis and hepatitis progression via immune cell infiltration; and in cancer, it promotes tumor growth, angiogenesis, metastasis, and immune evasion by recruiting tumor-associated macrophages (TAMs) and myeloid-derived suppressor cells (MDSCs) to the tumor microenvironment. Furthermore, CCR2 serves as a coreceptor with CD4 for HIV-1 viral entry into target cells, highlighting its role in infectious diseases. Due to these functions, CCR2 is a promising therapeutic target, with antagonists under investigation for inflammatory, cardiovascular, and oncologic conditions.^[1]^[4]^[5]

Genetics and Expression

Gene Location and Organization

The CCR2 gene is located on the short arm of human chromosome 3 at the cytogenetic band 3p21.31, within a cluster of chemokine receptor genes.^[1] Its genomic coordinates span from 46,353,864 to 46,360,940 base pairs on the GRCh38 reference assembly, encompassing approximately 7 kb of DNA.^[6] The gene consists of three exons, with the alternative splicing of the third exon generating the two primary protein isoforms, CCR2A and CCR2B, which differ in their C-terminal tails.^[7] The 5'-flanking promoter region, extending about 1.7 kb upstream of the translation start site, includes several putative regulatory elements such as GATA transcription factor binding sites, Oct-1 consensus sequences, and CAAT/enhancer-binding protein motifs that influence tissue-specific expression.^[8] A notable genetic variant is the CCR2-64I polymorphism (rs1799864), which results in a valine-to-isoleucine substitution at amino acid position 64 in the first extracellular loop of the receptor.^[7] This allele has a frequency of 7-10% in Caucasian populations, 20-30% in African populations, and intermediate levels (around 10-15%) in mixed or Asian cohorts, potentially influencing receptor function and disease susceptibility.^[9] A 2025 study identified rare damaging variants in CCR2 associated with lower lifetime risk of myocardial infarction and coronary artery disease in carriers.^[10] The CCR2 gene exhibits strong evolutionary conservation across mammals, with orthologs identified in over 500 species, including rodents, primates, and artiodactyls, underscoring its fundamental role in chemokine signaling.^[11] This conservation is marked by recurrent gene conversion events with the neighboring CCR5 gene in multiple mammalian lineages, which may enhance functional redundancy and heterodimerization.^[12]

Expression Patterns

CCR2 is primarily expressed on the surface of immune cells, including monocytes, macrophages, dendritic cells, and subsets of T cells, with the highest levels observed on classical monocytes (CD14⁺⁺CD16^- in humans and Ly6C^hi in mice). This expression enables these cells to respond to chemokine gradients for migration. Constitutive expression is prominent on circulating monocytes, where CCR2 levels remain steady under homeostatic conditions, facilitating basal trafficking from the bone marrow. However, expression is also inducible, with upregulation occurring in response to inflammatory stimuli such as cytokines including IFN-γ, TNF-α, and IL-1β, which enhance CCR2 surface density on monocytes, macrophages, and even non-immune cells like endothelial cells during inflammation. During hematopoiesis, CCR2 is expressed in the bone marrow on hematopoietic stem and progenitor cells as well as maturing monocytes, playing a key role in their mobilization and release into circulation. Species-specific differences in expression patterns are evident; for instance, in rodents, CCR2 exhibits higher basal and activation-induced expression in microglia compared to human microglia, where it is more selectively enriched on peripheral monocytes and infiltrating monocyte-derived macrophages in the central nervous system. This targeted expression underpins CCR2's role in immune cell recruitment to inflammatory sites.

Molecular Structure and Signaling

Protein Structure

CCR2 is a class A G protein-coupled receptor (GPCR) characterized by a seven-transmembrane domain topology, consisting of seven α-helical segments that span the plasma membrane, connected by three extracellular loops (ECLs) and three intracellular loops (ICLs). The N-terminal domain is extracellular and plays a role in ligand recognition, while the C-terminal domain is intracellular and involved in receptor regulation. This canonical architecture is conserved across chemokine receptors, with CCR2's structure resolved in multiple crystal structures, including those from 2016 and 2019, and a 2022 cryo-EM structure of the CCL2-bound CCR2-Gi complex, which confirm the typical GPCR fold with a central binding pocket formed by transmembrane helices (TMs) II, III, VI, and VII.^[3]^[13]^[14] The mature CCR2 protein comprises 374 amino acids and has a calculated molecular weight of approximately 42 kDa. It undergoes N-linked glycosylation primarily at asparagine 14 (Asn14) in the N-terminal extracellular domain, which contributes to proper folding, stability, and trafficking to the cell surface. Additional post-translational modifications include conserved disulfide bonds, such as between Cys32 in the N-terminus and Cys277 in ECL3, as well as between Cys113 in TM3 and Cys190 in ECL2, which stabilize the receptor's extracellular architecture.^[15]^[16]^[3] Insights into CCR2's three-dimensional structure derive from X-ray crystallography of constructs often featuring truncations of the flexible N- and C-termini to facilitate crystallization, revealing a ligand-binding pocket divided into major and minor subpockets for orthosteric antagonists. Homology models based on related GPCRs like CCR5 and CXCR4 have further informed the chemokine-binding site, highlighting key residues such as Glu291^{7.39} in TM7 for interactions with acidic ligands. The receptor exhibits potential for dimerization, observed in cellular contexts, which may influence its localization and signaling efficiency. Phosphorylation occurs on serine and threonine residues in the intracellular C-terminal tail, primarily mediated by G protein-coupled receptor kinases (GRKs) such as GRK2 and GRK3, facilitating desensitization and internalization.^[3]^[13]^[15]^[17]

Ligands and Activation

The CC chemokine receptor 2 (CCR2) primarily binds CCL2, also known as monocyte chemoattractant protein-1 (MCP-1), with high affinity, characterized by a dissociation constant (Kd) of approximately 1-2 nM. This interaction is essential for initiating chemokine signaling in immune cells. CCR2 also recognizes secondary ligands, including CCL7 (MCP-3), CCL8 (MCP-2), and CCL13 (MCP-4), though with generally lower potency compared to CCL2.^[4]^[14] Ligand binding to CCR2 occurs through a two-step mechanism involving initial interaction with the receptor's N-terminal domain, which acts as a primary "catch" site, followed by engagement of the extracellular loops to stabilize the complex and induce conformational changes in the transmembrane helices.^[18]^[19] Upon binding, particularly of CCL2, CCR2 couples to heterotrimeric Gαi proteins, leading to the dissociation of the Gαi subunit from the Gβγ complex. This activates downstream effectors, including the inhibition of adenylyl cyclase to reduce cyclic AMP levels and the mobilization of intracellular calcium stores via phospholipase Cβ activation.^[20]^[21] To prevent prolonged signaling, CCR2 undergoes rapid desensitization following ligand stimulation. This process involves phosphorylation of the receptor's C-terminal tail and intracellular loops by G protein-coupled receptor kinases (GRKs), particularly GRK2, which recruits β-arrestins to uncouple the receptor from Gαi proteins and promote internalization.^[21]^[17] β-Arrestin binding further attenuates signaling by sterically hindering G protein interactions and facilitating receptor endocytosis, thereby regulating the duration and specificity of chemokine responses.^[18]

Physiological Roles

In Immune Cell Recruitment

CCR2, a G protein-coupled receptor primarily expressed on monocytes and macrophages, plays a pivotal role in directing these cells to sites of inflammation through chemotactic guidance in response to CCL2 (also known as MCP-1) gradients. CCL2 binds to CCR2, triggering intracellular signaling cascades that enable gradient sensing and directed migration, a process essential for the recruitment of inflammatory monocytes from the bloodstream into tissues. This interaction allows monocytes to detect and follow decreasing concentrations of CCL2, facilitating their accumulation at inflammatory foci where CCL2 is produced by activated endothelial cells and resident tissue cells.^[22] In addition to chemotaxis, CCR2 mediates key steps in the vascular phase of immune cell infiltration, including transendothelial migration and diapedesis. Upon CCL2 stimulation, CCR2 activation promotes monocyte adhesion to the endothelium via upregulation of integrins such as LFA-1 and VLA-4, followed by cytoskeletal rearrangements that drive the cells across the endothelial barrier into the perivascular space. This process is critical for monocytes to exit the vasculature and enter inflamed tissues, ensuring efficient delivery of phagocytic and antigen-presenting functions. Studies using in vitro models of endothelial monolayers have demonstrated that CCR2 blockade significantly reduces monocyte diapedesis in response to CCL2, underscoring its necessity.^[23]^[24] Beyond innate immunity, CCR2 contributes to adaptive immune responses by facilitating the recruitment of Th1 cells, which express CCR2 and respond to CCL2 gradients to enhance IFN-γ production at inflammatory sites. This recruitment supports Th1 polarization and effector functions, bridging innate and adaptive immunity during infections or immune challenges. Experimental evidence from CCR2 knockout mouse models highlights the receptor's indispensability, as these animals exhibit severely impaired monocyte trafficking to inflammatory sites, resulting in reduced macrophage infiltration and compromised host defense against pathogens like Toxoplasma gondii. Such defects persist even in adoptive transfer experiments, confirming CCR2's direct role in monocyte mobilization and extravasation without compensatory mechanisms.^[25]^[26]

In Tissue Homeostasis

CCR2 contributes to tissue homeostasis by regulating the basal circulation and patrolling of monocytes in healthy vasculature. In steady-state conditions, CCR2 facilitates the egress of Ly6C-high inflammatory monocytes from the bone marrow into the peripheral blood, maintaining monocyte homeostasis without overt inflammation.^[27] This process ensures a steady supply of circulating monocytes that can patrol vascular endothelium, removing cellular debris and supporting endothelial integrity. Although non-classical monocytes primarily perform patrolling functions via CX3CR1, CCR2-dependent monocytes contribute to vascular surveillance by responding to low-level chemokine signals, such as CCL2, produced by endothelial cells under homeostatic conditions.^[28] In wound healing and tissue repair, CCR2 orchestrates controlled infiltration of macrophages to promote resolution and regeneration. Upon tissue injury, CCR2 mediates the recruitment of CCR2-positive monocytes, which differentiate into macrophages that clear debris, secrete growth factors, and facilitate extracellular matrix remodeling. Studies in murine models of skin and fracture wounds demonstrate that CCR2 deficiency impairs early inflammatory resolution and delays healing, with reduced macrophage accumulation leading to persistent inflammation and defective tissue regeneration.^[29] For instance, in excisional wound models, CCR2 promotes timely monocyte influx, enabling efficient re-epithelialization and collagen deposition without excessive fibrosis.^[30] CCR2 supports angiogenesis and vascular integrity through recruitment of macrophages during homeostatic maintenance and repair. CCR2-positive macrophages, derived from recruited monocytes, promote vascularization by secreting factors such as VEGF-A. In tissue repair contexts, such as skin wound healing and fracture repair, CCR2-dependent macrophages contribute to vascular maturation.^[31]^[29] This mechanism ensures proper blood flow and nutrient delivery, contributing to overall vascular homeostasis.^[32] In the brain, CCR2 enables steady-state functions related to macrophage surveillance at the central nervous system borders. CCR2-positive monocytes replenish border-associated macrophages (BAMs) in regions like the meninges and choroid plexus, where these cells monitor cerebrospinal fluid and maintain immune quiescence. This replenishment supports microglial-like surveillance without disrupting parenchymal homeostasis, as BAMs derived from CCR2-dependent precursors help regulate low-level immune responses and synaptic pruning indirectly.^[33] Deficiency in CCR2 reduces BAM turnover, potentially compromising barrier integrity under basal conditions.^[34]

Pathophysiological Involvement

In Neurodegenerative Diseases

The CCL2-CCR2 axis plays a dual role in Alzheimer's disease (AD), initially promoting the recruitment of microglia to amyloid-β plaques to facilitate clearance, but leading to chronic neuroinflammation when persistently activated. In APP/PS1 transgenic mouse models of AD, CCR2 deficiency impairs microglial accumulation at plaques, resulting in accelerated amyloid-β deposition and worsened cognitive deficits, underscoring the protective aspect of acute CCR2 signaling. However, prolonged CCL2-CCR2 engagement exacerbates pathology by sustaining pro-inflammatory microglial states, as evidenced by studies showing that CCL2 overexpression in amyloidosis models enhances glial activation and amyloid oligomerization without resolving plaques.^[35]^[36] In multiple sclerosis (MS), CCR2 facilitates the entry of T cells and macrophages into the central nervous system (CNS), contributing to demyelination and lesion formation. CCR2-expressing Ly-6C^hi monocytes are rapidly recruited to inflamed CNS sites in experimental autoimmune encephalomyelitis (EAE), the primary animal model of MS, where they drive the effector phase of disease by promoting T-cell reactivation and myelin damage.^[37] CCR2 knockout mice exhibit reduced mononuclear phagocyte infiltration and attenuated EAE severity, confirming CCR2's essential role in leukocyte transmigration across the blood-brain barrier and subsequent neuroinflammatory cascades.^[38] CCR2 contributes to Parkinson's disease (PD) through microglial activation in the substantia nigra, where it mediates the infiltration of peripheral pro-inflammatory monocytes that amplify dopaminergic neuron loss. In α-synuclein overexpression models, CCR2⁺ peripheral monocytes enter the substantia nigra, inducing robust microglial activation and neuroinflammation that parallels PD pathology.^[39] Blocking CCR2 reduces this monocyte influx and mitigates neuronal damage, highlighting its role in propagating the inflammatory milieu in PD.^[40] Recent studies also implicate the CCL2-CCR2 axis in amyotrophic lateral sclerosis (ALS), where it drives the recruitment of immune cells to neuromuscular junctions, promoting denervation and motor neuron degeneration in mouse models. Inhibition of this axis reduces immune infiltration and preserves neuromuscular function, suggesting a pro-pathological role in ALS progression.^[41] Human studies across neurodegenerative diseases reveal elevated CCL2 levels in cerebrospinal fluid (CSF), correlating with disease presence and severity, alongside CCR2 genetic variants influencing progression. Higher baseline CSF CCL2 levels in prodromal stages predict faster cognitive decline over follow-up in AD.^[42] In PD, CSF CCL2 concentrations are notably elevated relative to serum, reflecting heightened CNS inflammation.^[43] For MS, CSF CCL2 exceeds serum levels, indicating intrathecal production that supports ongoing immune cell trafficking.^[44] Genetic analyses show that the CCR2 V64I variant (rs1799864 A allele) is associated with altered CCL2 expression and accelerated AD progression, while in MS, the same variant confers protection against disease onset.^[45]^[46]

In Metabolic and Cardiovascular Disorders

CCR2 plays a central role in obesity by facilitating the recruitment of monocytes to adipose tissue, where they differentiate into macrophages that promote chronic inflammation and insulin resistance. In high-fat diet (HFD) models, CCR2 mediates the infiltration of proinflammatory macrophages into expanding adipose depots, leading to the release of cytokines such as TNF-α and IL-6, which impair insulin signaling in adipocytes and hepatocytes. Studies in CCR2-deficient mice demonstrate reduced macrophage accumulation in adipose tissue, attenuated inflammation, and protection against HFD-induced weight gain and glucose intolerance, highlighting CCR2's necessity for these pathological processes.^[47] In myocardial infarction (MI), CCR2 orchestrates the recruitment of Ly-6C^high monocytes to the infarcted heart, which is essential for the initial inflammatory response and subsequent tissue repair through phagocytosis of debris and promotion of angiogenesis. However, excessive CCR2-dependent monocyte influx can exacerbate adverse left ventricular remodeling by sustaining prolonged inflammation and fibrosis, contributing to heart failure progression. Targeted inhibition of CCR2, such as through RNAi-mediated silencing, reduces monocyte recruitment post-MI, limits inflammatory damage, and improves cardiac function in mouse models without compromising reparative mechanisms.^[48]^[49] CCR2 also contributes to atherosclerosis by directing CCR2⁺ monocytes into arterial plaques, where they differentiate into lipid-laden foam cells that drive plaque progression and instability. These CCR2⁺ inflammatory monocytes, primarily the Ly-6C^high subset in mice, extravasate in response to CCL2 gradients, uptake oxidized LDL, and form foam cells that amplify local inflammation via cytokine production and matrix metalloproteinase secretion. In apolipoprotein E-deficient models, CCR2 deficiency significantly reduces monocyte infiltration and atherosclerotic lesion size, underscoring its proatherogenic role.^[50]^[51] Human studies provide evidence linking CCR2 to metabolic and cardiovascular disorders, with polymorphisms such as the CCR2 1908G>A variant associated with increased risk of metabolic syndrome through enhanced monocyte activation and insulin resistance. Additionally, elevated CCR2 expression on circulating monocytes is observed in patients with type 2 diabetes, correlating with inflammatory markers and contributing to diabetic cardiomyopathy by promoting cardiac monocyte infiltration and fibrosis.^[52]^[53]^[54]

Clinical and Therapeutic Relevance

As a Biomarker

Circulating levels of CCL2, the primary ligand for CCR2, have been investigated as a biomarker for systemic inflammation across various conditions. In rheumatoid arthritis (RA), elevated plasma CCL2 concentrations correlate with increased joint infiltration by monocytes and macrophages, reflecting disease activity and progression. Similarly, in cancer, higher circulating CCL2 levels are observed in patients with malignancies such as mesothelioma and prostate cancer, where they associate with tumor stage and metastatic potential, serving as a prognostic indicator of disease severity. During infections, including COVID-19 and chronic hepatitis B virus infection, CCL2 levels rise in plasma, mirroring the extent of immune cell recruitment and inflammatory response, which aids in monitoring acute and chronic infectious states. Soluble forms of CCR2 (sCCR2) in plasma have emerged as indicators of monocyte activation, particularly in cardiovascular diseases. In patients with abdominal aortic aneurysm (AAA), a form of vascular pathology, elevated sCCR2 levels correlate with enhanced monocyte recruitment to the vessel wall, providing a measure of inflammatory burden and potential risk for aneurysm progression. This soluble receptor, which acts as a decoy for CCL2, reflects ongoing monocyte mobilization and may help assess cardiovascular risk in susceptible individuals by quantifying activation states without invasive procedures. Genetic variants in the CCR2 gene, such as the CCR2-64I polymorphism (V64I), are used in testing to predict therapeutic responses and disease trajectories. In HIV-1 infection, individuals carrying the CCR2-64I allele exhibit slower disease progression, with lower viral loads and delayed CD4+ T-cell decline, enabling personalized prognostic assessments and guiding antiretroviral therapy initiation. This variant's protective effect highlights CCR2 genotyping as a tool for stratifying HIV patients based on expected response to treatment. Despite these applications, CCR2 and CCL2 biomarkers face limitations due to their non-specificity, as elevated levels occur in multiple overlapping pathologies including inflammation, cancer, and neurodegeneration, complicating disease-specific diagnosis. In Alzheimer's disease (AD), plasma CCL2 levels correlate with amyloid-β accumulation on positron emission tomography (PET) imaging and faster cognitive decline, but their broad associations reduce diagnostic precision without integration with other markers like neuroimaging.

Therapeutic Targeting

Therapeutic targeting of CCR2 primarily involves antagonists and antibodies designed to inhibit monocyte recruitment and mitigate inflammation in various diseases. CCR2 antagonists, such as the small-molecule inhibitor CCX140-B, have been evaluated in Phase II clinical trials for diabetic nephropathy, where they reduced residual albuminuria in patients with type 2 diabetes when added to standard renin-angiotensin system blockade.^[55] Similarly, propagermanium, another CCR2 inhibitor, was tested in a randomized pilot trial for patients with type 2 diabetes and nephropathy, demonstrating good tolerability as an add-on to irbesartan but no significant reduction in albuminuria at a 30 mg daily dose over 12 months.^[56] Anti-CCR2 antibodies, including MLN1202 (also known as plozalizumab), have been investigated in clinical settings for inflammatory conditions. In a Phase II trial for relapsing-remitting multiple sclerosis, subcutaneous MLN1202 administration was safe and well-tolerated but did not demonstrate significant efficacy in reducing disease activity.^[57] For atherosclerosis, a proof-of-mechanism study using MLN1202 showed reductions in arterial inflammation as measured by FDG-PET imaging in patients with stable cardiovascular disease, supporting its potential to modulate CCR2-mediated monocyte activity in plaques.^[58] Despite promising preclinical data, clinical development of CCR2 modulators faces challenges, including functional redundancy with other chemokine receptors like CCR5 and CXCR2, which can compensate for CCR2 inhibition and limit efficacy.^[59] Additionally, blockade of CCR2 may impair innate immunity, leading to side effects such as increased susceptibility to infections, as observed in some trials where monocyte function was altered.^[60] Emerging strategies include advanced small-molecule inhibitors, such as the dual CCR2/CCR5 antagonist BMS-813160, which is in Phase 2 clinical trials as of 2025 for solid tumors including pancreatic ductal adenocarcinoma and non-small cell lung cancer in combination with immunotherapies like nivolumab.^[61] Nucleic acid-based approaches like monocyte-directed RNAi targeting CCR2, which in mouse models of myocardial infarction reduced Ly-6C-high monocyte infiltration, attenuated inflammation, and improved left ventricular remodeling with smaller infarct sizes, continue to show preclinical promise.^[48] Recent advances in structure-based drug design for CCR2 inhibitors, as reviewed in 2025, highlight ongoing efforts to overcome previous clinical challenges through improved selectivity and potency.^[62] Gene therapy concepts, such as CCR2 knockdown, have shown translation potential from animal models to human applications by curbing excessive monocyte responses in ischemic tissues.^[59]

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