Death as rebirth: how efferocytosis drives tissue repair and disease treatment

Efferocytosis is a crucial process by which apoptotic cells are removed by phagocytes such as macrophages. It not only maintains tissue homeostasis and immune tolerance, but also plays a central role in tissue repair and disease regulation. In recent years, dysfunction of efferocytosis has been found to be closely related to various diseases, such as atherosclerosis, cancer, and chronic inflammatory conditions. Activating or remodeling efferocytosis has become a key direction in regenerative medicine and precision therapy. This review systematically summarizes the molecular mechanisms and immunomodulatory functions of efferocytosis, highlights its roles in various models of tissue injury and repair, and explores recent advances in targeted modulation of efferocytosis using nanomaterials, biomaterial scaffolds, and hydrogels. By focusing on the biological logic of "life from death," this article aims to provide a theoretical foundation and strategic support for the translational applications of efferocytosis in tissue engineering, immunotherapy, and disease intervention. Furthermore, it highlights the synergistic potential of combining nanomaterials, hydrogels, and biological scaffolds to create next-generation efferocytosis-driven therapies, thereby offering a multidisciplinary perspective on overcoming current challenges in clinical translation. Specifically, this synergistic strategy holds particular promise in addressing key clinical challenges such as overcoming tumor immunosuppression and promoting vascularization in chronic wounds, providing a targeted approach to enhance therapeutic outcomes in these complex pathological contexts.