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The transition between these phases is crucial for cardiac recovery, but the key factors remain unclear. Meteorin-like (Metrnl) promotes anti-inflammatory\/reparative macrophage polarization in the myocardium, yet its role in the acute phase post-MI is unknown. We observed that macrophages infiltrating the ischemic myocardium produced elevated levels of Metrnl in both the heart and circulation 4\u00a0days post-MI. The absence of Metrnl in\n                    <jats:italic>Metrnl\u207b\/\u207b<\/jats:italic>\n                    mice altered myocardial healing and remodeling, with an increased presence of macrophages with a more pro-inflammatory phenotype. Conversely, cardiac Metrnl overexpression restored myocardial repair and promoted a shift toward a more anti-inflammatory\/reparative macrophage phenotype. Mechanistically, Metrnl regulated macrophage-dependent production of Oncostatin M (Osm), a key cytokine in the early inflammatory phase post-MI that induces cardiomyocyte production of Reg3\u03b2. Reg3\u03b2, in turn, limits pro-inflammatory macrophage activation and polarization while modulating their trafficking, ultimately influencing the duration and intensity of the pro-inflammatory phase post-MI. Thus, Metrnl plays a crucial role in cardiac repair by modulating the acute phase following myocardial infarction through its regulation of macrophage populations.\n                  <\/jats:p>","DOI":"10.1007\/s00395-026-01203-7","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:32:27Z","timestamp":1785490347000},"page":"987-1010","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Meteorin-like regulates cardiac repair via macrophage modulation following myocardial infarction"],"prefix":"10.1007","volume":"121","author":[{"given":"G.","family":"Ferrer-Curriu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Blasco-Roset","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Navarro-Gascon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Soler-Botija","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. 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