This study demonstrates a synergistic action of prostaglandin E and GM-CSF which causes the release of pro-tolerant cytokines in two monocyte cell lines: U937 and ML-1. The prostaglandin effect is cyclic AMP dependent since stimulators of adenyl cyclase such as forskolin (fsk) can replace PGE. Fsk and GM-CSF combinations raised messenger RNA for IL-10, interleukin-1 receptor antagonist (IL-1ra), and CD14 as well as the released proteins. Effective levels of interleukin 12 are reduced. In these respects, the monocyte cells resemble the alternatively activated or tumour associated macrophages. A differential pattern in co-stimulatory molecule expression is seen: CD80 is unchanged but CD86 is markedly elevated and such a change is not seen in the alternatively activated macrophage but has been previously reported in monocytes resident in the non-inflamed gut. Control of leukocyte responses by two agents acting in synergy could be effective in critical situations Such as discrimination between pathogens and commensal bacteria, etc. Monocytes modifed in such a way could provide a pro-tolerant environment (high IL-10, low IL-12) for antigen presentation by dendritic cells and thus may contribute to a normally permissive milieu, e.g.. for food absorption. © 2005 Elsevier Inc. All rights reserved.