We have previously demonstrated that constant 20 mmHg extracellular pressure increases serumopsonized latex bead phagocytosis by phorbol 12-myristate 13-acetate (PMA)-differentiated THP-1 macrophages in part by inhibiting focal adhesion kinase (FAK) and extracellular signal-regulated kinase (ERK). Because p38 MAPK is activated by physical forces in other cells, we hypothesized that modulation of p38 MAPK might also contribute to the stimulation of macrophage phagocytosis by pressure. We studied phagocytosis in PMA-differentiated THP-1 macrophages, primary human monocytes, and human monocyte-derived macrophages (MDM). p38 MAPK activation was inhibited using SB-203580 or by p38 MAPK␣ small interfering RNA (siRNA). Pressure increased phagocytosis in primary monocytes and MDM as in THP-1 cells. Increased extracellular pressure for 30 min increased phosphorylated p38 MAPK by 46.4 Ϯ 20.5% in DMSO-treated THP-1 macrophages and by 20.9 Ϯ 9% in primary monocytes (P Ͻ 0.05 each). SB-203580 (20 M) reduced basal p38 MAPK phosphorylation by 34.7 Ϯ 2.1% in THP-1 macrophages and prevented pressure activation of p38. p38 MAPK␣ siRNA reduced total p38 MAPK protein by 50 -60%. Neither SB-203580 in THP-1 cells and peripheral monocytes nor p38 MAPK siRNA in THP-1 cells affected basal phagocytosis, but each abolished pressure-stimulated phagocytosis. SB-203580 did not affect basal or pressure-reduced FAK activation in THP-1 macrophages, but significantly attenuated the reduction in ERK phosphorylation associated with pressure. p38 MAPK␣ siRNA reduced total FAK protein by 40 -50%, and total ERK by 10 -15%, but increased phosphorylated ERK 1.4 Ϯ 0.1-fold. p38 MAPK␣ siRNA transfection did not affect the inhibition of FAK-Y397 phosphorylation by pressure but prevented inhibition of ERK phosphorylation. Changes in extracellular pressure during infection or inflammation regulate macrophage phagocytosis by a FAKdependent inverse effect on p38 MAPK␣ that might subsequently downregulate ERK.force; inflammation; infection; leukocyte; mechanotransduction; signal transduction MONOCYTES AND MACROPHAGES are recruited to sites of inflammation and play critical roles in innate host defense mechanisms. Tissue pressure is often altered in association with inflammation or infection. Mechanical stimuli such as pressure are known to modulate cellular morphology and function in other cell types (7,38,39,73,79). We have previously reported that constant low extracellular pressure increases phagocytosis by phorbol 12-myristate 13-acetate (PMA)-differentiated THP-1 macrophages (67). Although focal adhesion kinase (FAK) and extracellular signal-regulated kinase (ERK) are activated by physical force caused by pressure in some other cell types (2,4,44,75,76,80), the effect of pressure on macrophage phagocytosis appears partially mediated by inhibition of a FAK-ERK signal pathway (67). Like ERK, the mitogen-activated protein kinase (MAPK) p38 is activated by various stress stimuli, including lipopolysaccharide (LPS) stimulation in macrophages and physical force...