Macrophage-driven pathogenesis in acute lung injury/acute respiratory disease syndrome: Harnessing natural products for therapeutic interventions (Review)

Abstract

Acute lung injury (ALI ) or acute respiratory distress syndrome (ARD S) is a common respiratory disease characterized by hypoxemia and respiratory distress. It is associated with high morbidity and mortality. Due to the complex pathogenesis of ALI , the clinical management of patients with ALI /ARD S is challenging, resulting in numerous post-treatment sequelae and compromising the quality of life of patients. Macrophages, as a class of innate immune cells, play an important role in ALI /ARD S. In recent years, the functions and phenotypes of macrophages have been better understood due to the development of flow cytometry, immunofluorescence, single-cell sequencing and spatial genomics. However, no macrophage-targeted drugs for the treatment of ALI /ARD S currently exist in clinical practice. Natural products are important for drug development, and it has been shown that numerous natural compounds from herbal medicine can alleviate ALI /ARD S caused by various factors by modulating macrophage abnormalities. In the present review, the natural products from herbal medicine that can modulate macrophage abnormalities in ALI /ARD S to treat ALI /ARD S are introduced, and their mechanisms of action, discovered in the previous five years (2019-2024), are presented. This will provide novel ideas and directions for further research, to develop new drugs for the treatment of ALI /ARD S.