Molecular mechanisms of macrophage migration inhibitory factor in related diseases (Review).

Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine that exerts dual-faced, context-dependent roles in physiological and pathological processes. While it maintains tissue homeostasis and facilitates repair under normal conditions, MIF acts as a 'double-edged sword' following tissue injury. As a primary initiator of early inflammatory responses, MIF regulates immune cell activation, oxidative stress, and downstream inflammatory cascades. The present review focuses on the molecular mechanisms and therapeutic potential of MIF signaling in three critical inflammation-related conditions: Cerebral infarction, atherosclerosis, and acute kidney injury. It is first delineated how MIF signaling pathways drive disease progression or protection. Furthermore, recent advancements in MIF-targeted therapies are summarized, and the intricate regulatory factors, including dosage, timing, and microenvironmental cues, that govern its bifunctional nature are examined. By highlighting current clinical challenges and prospects, the present review underscores the potential of MIF as a precise therapeutic target for systemic inflammatory diseases.