Role of Macrophage Polarization in Acute Respiratory Distress Syndrome
Abstract
:1. Introduction
2. Etiology
3. Pathophysiology
4. Biomarkers
5. Based on Anatomical Regions
6. Division Depending on Polarization
- (A) M1-type (classically activated macrophages (CAMs) or pro-inflammatory).
- (B) M2-type (alternatively activated macrophages (AAMs) or anti-inflammatory).
- (C) Regulatory Macrophages (Mreg).
7. Functional Role of Macrophages in Human Physiology
8. Molecular Mechanism of Macrophage in ARDS
9. Discussion
- How do these macrophages decide the level of inflammatory cytokine and neutrophil production?
- How do they interact with localised endothelial cells from airway epithelial progenitors during the regeneration process?
10. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Features | Ausbugh and Petty 1967 [3] | AECC Definition 1994 [4] | Berlin Definition 2012 [5] |
---|---|---|---|
Timing | Acute not specified | Acute, time frame is still missing | Specified timeline-maximum within a week after insult |
Oxygenation ALI/ARDS | Not specified | <300 for ALI <200 for ARDS PEEP is not considered in this | Mild: 201–300 Moderate: 101–200 Severe: <100 Based on PaO2/FiO2, with PEEP ≥ 5 cm H2O |
Chest radiograph | Patchy bilateral alveolar infiltrations | Chest X-ray with bilateral pulmonary infiltrations | Chest radiograph criteria clarified Example radiographs created |
PAWP (Pulmonary Artery Wedge Pressure) | Not mentioned | PAWP 18 mm Hg when measured or no clinical evidence of left atrial hypertension | PAWP requirement removed Hydrostatic oedema is not the primary cause of respiratory failure Clinical vignettes were created to help exclude hydrostatic oedema |
Risk factors | The initial study included 12 multifactorial patients | Not specified | Included When none is identified, need to objectively rule out hydrostatic oedema |
Direct Lung Injury/Pulmonary Injury | Indirect Lung Injury/Extra-Pulmonary Injury |
---|---|
Common Pneumonia Aspiration of gastric contents Less Common Pulmonary contusion Fat/Amniotic fluid embolism High Altitude Near Drowning Inhalation Injury Reperfusion Injury | Common Sepsis Severe trauma with shock and multiple transfusions Less Common Burns Disseminated intravascular coagulation Cardiopulmonary bypass Drug overdose (heroin, barbiturates) Acute pancreatitis Transfusion of blood products Hypoproteinaemia |
Macrophage Subtype | Stimuli | Markers | References |
---|---|---|---|
M1 | IFN LPS TNFα | CD80, CD86, CD64, CD16 and CD32 iNOS | [9] |
M2a | IL-4, IL-13 and M-CSF | CD206, Arg1, Ym1, FIZZ1 IL-10, TGF-β | [9,10] |
M2b | TLR ligands + IL-1R agonist | CD206, IL-1 β, IL-6, TNF-α, IL-12Low IL-10 | [11] |
M2c | IL-10, Glucocorticoids, TGF-β | CD206, CD163, MerTK IL-10, TGF-β | [12] |
M2d | TLR + adenosine A2A R ligands, IL-6 | VEGF, IL-10 TGF-β IL-12Low, TNF-αLow | [13] |
S.No. | Anatomical Location | Types of Macrophages |
---|---|---|
1 | Adipose Tissue | Adipose tissue macrophages |
2 | Bone marrow/blood | Monocytes |
3 | Liver | Kupffer cells |
4 | Lymph nodes | Sinus histocytes |
5 | Pulmonary Alveoli of lungs | Alveolar macrophages (dust cells) |
6 | Connective tissue | Histiocytes leading to giant cell |
7 | Central Nervous System | Microglia |
8 | Placenta | Hofbauer cells |
9 | Kidney | Intra glomerular mesengial cells |
10 | Bone | Osteoclasts |
11 | Granulomas | Epitheloid cells |
12 | Spleen (Red Pulp) | Red pulp macrophages (sinusoidal) |
13 | Peritoneal cavity | Peritoneal macrophages |
14 | Peyer’s Patch | Lysomac |
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Mishra, P.; Pandey, N.; Pandey, R.; Tripathi, Y.B. Role of Macrophage Polarization in Acute Respiratory Distress Syndrome. J. Respir. 2021, 1, 260-272. https://doi.org/10.3390/jor1040024
Mishra P, Pandey N, Pandey R, Tripathi YB. Role of Macrophage Polarization in Acute Respiratory Distress Syndrome. Journal of Respiration. 2021; 1(4):260-272. https://doi.org/10.3390/jor1040024
Chicago/Turabian StyleMishra, Priyanka, Nikhil Pandey, Ratna Pandey, and Yamini B Tripathi. 2021. "Role of Macrophage Polarization in Acute Respiratory Distress Syndrome" Journal of Respiration 1, no. 4: 260-272. https://doi.org/10.3390/jor1040024