Centre for Heart Lung Innovation, Department of Medicine, University of British Columbia, Vancouver V6Z1Y6, BC, Canada.
Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu City 807-8555, Fukuoka, Japan.
Clin Sci (Lond). 2020 Jul 17;134(13):1631-1635. doi: 10.1042/CS20200382.
Lung macrophages (LMs) are key immune effector cells that protect the lung from inhaled particulate matter, noxious gases and pathogens. In Chronic Obstructive Pulmonary Disease (COPD), there is an abundance of macrophages in airspaces and lung tissues suggesting that they play an important role in the pathogenesis of the disease. Furthermore, macrophage phenotype and functional properties are altered in COPD toward a more pro-inflammatory state, characterized by reduced pathogen recognition and processing ability and dysfunctional tissue repair qualities. Inhaled corticosteroids (ICSs), used in the management of COPD, has been shown to reduce acute exacerbations of COPD but is also associated with increased occurrence of pneumonia. Corticosteroids treatment altered LM phenotypic characteristics and their functional properties, and this commentary discusses current knowledge and also the gaps in our understanding of the impact of ICS on LMs phenotype and function. A better understanding of how ICSs impact the immune-inflammatory responses in the lung, in particular ICSs' effects on LMs, could allow more selective personalized tailoring of the use of ICSs in COPD to improve disease progression, morbidity and mortality.
肺巨噬细胞（LMs）是保护肺部免受吸入性颗粒物、有害气体和病原体侵害的关键免疫效应细胞。在慢性阻塞性肺疾病（COPD）中，肺泡和肺组织中存在大量的巨噬细胞，这表明它们在疾病的发病机制中发挥着重要作用。此外，COPD 中的巨噬细胞表型和功能特性发生改变，向更具炎症性的状态发展，其特征是病原体识别和处理能力降低以及组织修复功能障碍。用于 COPD 治疗的吸入性皮质类固醇（ICS）已被证明可减少 COPD 的急性加重，但也与肺炎发生率的增加有关。皮质类固醇治疗改变了 LM 的表型特征及其功能特性，本评论讨论了目前对 ICS 对 LMs 表型和功能影响的认识和理解差距。更好地了解 ICS 如何影响肺部的免疫炎症反应，特别是 ICS 对 LMs 的影响，可能会使我们能够更有针对性地个性化调整 COPD 中 ICS 的使用，从而改善疾病进展、发病率和死亡率。
