Sandhu Karanjot K, Scott Aaron, Tatler Amanda L, Belchamber Kylie B R, Cox Michael J
Department of Microbes, Infection and Microbiomes, Institute of Microbiology and Infection, School of Infection, Inflammation and Immunity, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Department of Inflammation and Ageing, School of Infection, Inflammation and Immunity, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Eur Respir Rev. 2024 Dec 4;33(174). doi: 10.1183/16000617.0053-2024. Print 2024 Oct.
COPD is a heterogeneous disease of the lungs characterised by restricted airflow. Chronic inflammation and recurrent bacterial infections are known to be important driving factors in exacerbations of this disease. Despite a marked increase in the number of alveolar macrophages present in the lungs of COPD patients, there is evidence of reduced clearance of pathogenic bacteria, leading to recurrent infection, exacerbation and subsequent lung function decline. This is thought to be attributed to a defect in the phagocytic capability of both alveolar and monocyte-derived macrophages in COPD. In addition to this defect, there is apparent selectivity in bacterial uptake by COPD macrophages because certain pathogenic genera, such as , and , are taken up more readily than others. The respiratory microbiome plays a key role in regulating the host immune response both in health and during chronic inflammation. In patients with COPD, there are distinct changes in the composition of the respiratory microbiome, particularly the lower respiratory tract, where dominance of clinically relevant pathogenic species is commonly observed. Whether there are links between these changes in the microbiome and dysfunctional macrophage phagocytosis has not yet been widely studied. This review aims to discuss what is currently known about these phenomena and to explore interactions between macrophages and the respiratory microbiome.
慢性阻塞性肺疾病（COPD）是一种以气流受限为特征的异质性肺部疾病。已知慢性炎症和反复细菌感染是该疾病急性加重的重要驱动因素。尽管COPD患者肺部的肺泡巨噬细胞数量显著增加，但有证据表明病原菌清除能力下降，导致反复感染、急性加重以及随后的肺功能下降。这被认为归因于COPD中肺泡巨噬细胞和单核细胞来源巨噬细胞吞噬能力的缺陷。除了这种缺陷外，COPD巨噬细胞在细菌摄取方面存在明显的选择性，因为某些病原菌属，如 、 和 ，比其他菌属更容易被摄取。呼吸道微生物群在健康和慢性炎症期间调节宿主免疫反应中起关键作用。在COPD患者中，呼吸道微生物群的组成存在明显变化，特别是在下呼吸道，临床上相关病原菌占优势的情况普遍可见。微生物群的这些变化与巨噬细胞吞噬功能障碍之间是否存在联系尚未得到广泛研究。本综述旨在讨论目前对这些现象的了解，并探讨巨噬细胞与呼吸道微生物群之间的相互作用。
