Scavenger receptor CD163 contains nine scavenger receptor cysteine-rich (SRCR) domains and because of the presence of this ancient and highly conserved protein motif, CD163 belongs to the SRCR superfamily. Expression of CD163 is restricted to cells of the monocyte/macrophage lineage and is tightly regulated, with a general tendency of anti-inflammatory signals to induce CD163 synthesis, while pro-inflammatory signals rather seem to downregulate CD163 expression. The first-identified and most-studied function of CD163 is related to its capacity to bind and internalize haemoglobin-haptoglobin (HbHp) complexes. Later on, its functional repertoire was expanded, with the identification of CD163 as an erythroblast adhesion receptor, a receptor for tumour necrosis factor-like weak inducer of apoptosis (TWEAK), as well as a receptor for distinct pathogens encompassing bacteria and viruses. Interaction of one of these ligands with CD163 might result in receptor-mediated endocytosis, but might as well trigger a signalling cascade leading to the secretion of signalling molecules, which implicates that CD163 also acts as an immunomodulator. Not only the membrane-bound form of CD163 has an immunomodulating capacity, but also soluble CD163, which is generated via ectodomain shedding, is able to exert anti-inflammatory effects. Furthermore, the concentration of this soluble protein is significantly increased under specific pathological conditions, making it a useful marker protein for certain diseases. Finally, its restricted expression pattern and potential to internalize make CD163 an attractive candidate as gateway for cell-directed (immuno)therapy. This review aims to summarize current knowledge on CD163's biology and its different biological functions beyond HbHp scavenging, thereby mainly focussing on the more recently discovered ones. Furthermore, current data supporting the capacity of CD163 to serve as a diagnostic marker in certain diseases and its potential as a target molecule for cell-directed therapy are surveyed.
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