Department of Veterinary and Animal Sciences, University of Massachusetts Amherst, Amherst, MA01003, USA.
Molecular and Cellular Biology Graduate Program, University of Massachusetts Amherst, Amherst, MA01003, USA.
Expert Rev Mol Med. 2021 Nov 26;23:e18. doi: 10.1017/erm.2021.21.
Alveolar macrophages (AMs) are lung-resident myeloid cells that sit at the interface of the airway and lung tissue. Under homeostatic conditions, their primary function is to clear debris, dead cells and excess surfactant from the airways. They also serve as innate pulmonary sentinels for respiratory pathogens and environmental airborne particles and as regulators of pulmonary inflammation. However, they have not typically been viewed as primary therapeutic targets for respiratory diseases. Here, we discuss the role of AMs in various lung diseases, explore the potential therapeutic strategies to target these innate cells and weigh the potential risks and challenges of such therapies. Additionally, in the context of the COVID-19 pandemic, we examine the role AMs play in severe disease and the therapeutic strategies that have been harnessed to modulate their function and protect against severe lung damage. There are many novel approaches in development to target AMs, such as inhaled antibiotics, liposomal and microparticle delivery systems, and host-directed therapies, which have the potential to provide critical treatment to patients suffering from severe respiratory diseases, yet there is still much work to be done to fully understand the possible benefits and risks of such approaches.
肺泡巨噬细胞（AMs）是肺驻留的髓样细胞，位于气道和肺组织的交界处。在稳态条件下，它们的主要功能是清除气道中的碎片、死细胞和过多的表面活性剂。它们还作为呼吸道病原体和环境空气传播颗粒的先天肺哨兵，以及肺部炎症的调节剂。然而，它们通常不被视为呼吸道疾病的主要治疗靶点。在这里，我们讨论了 AMs 在各种肺部疾病中的作用，探讨了针对这些先天细胞的潜在治疗策略，并权衡了这些治疗的潜在风险和挑战。此外，在 COVID-19 大流行的背景下，我们研究了 AMs 在严重疾病中的作用，以及已经利用的调节其功能和防止严重肺损伤的治疗策略。目前有许多针对 AMs 的新方法正在开发中，例如吸入性抗生素、脂质体和微粒传递系统以及宿主定向治疗，这些方法有可能为患有严重呼吸系统疾病的患者提供关键治疗，但仍有许多工作要做，以充分了解这些方法的可能益处和风险。
