Previous studies have shown that mouse M1-type macrophages are pro-inflammatory, whereas M2-type macrophages are anti-inflammatory, release IL-10, and exhibit significant phagocytic activity ( Macrophages can secrete elastolytic enzymes, including MMP-2, MMP-9, and MMP-12 ( Monocytes from COPD patients exhibit a stronger chemotactic response to CXCL1 than monocytes from smokers and non-smokers ( It has been shown that in healthy individuals and smokers, corticosteroids inhibit the release of CXCL8, TNF- and MMP-9 from macrophages, thereby alleviating the inflammatory response, but in patients with COPD, where the inflammatory response is mainly mediated by cytokines, chemokines and proteases, corticosteroid use is ineffective ( Both alveolar-derived macrophages and monocyte-derived macrophages in patients with COPD exhibit reduced phagocytic uptake of bacteria, which may be the result of long-term colonization of the lower airways by bacteria such as Haemophilus influenzae or Streptococcus pneumoniae ( 3.3 Neutrophils Increased sputum and BALF neutrophilia is a typical feature of COPD, and this neutrophil-induced inflammation can caused by regular exposure to cigarette smoke, infectious agent and oxidative stress ( Neutrophils secrete several serine proteases including neutrophil elastase (NE), cathepsin G, proteinase-3, MMPs and myeloperoxidase (MPO) which may contribute to the alveolar damage ( It has been suggested that the size and extent of the neutrophil traffic may be related to the pathological changes that occur in individuals with COPD in case of emphysema ( The above findings have implications for the precise treatment of COPD
Competing interests SMN served as a paid expert witness in litigation against tobacco and e-cigarette companies
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