Lung macrophages constitute the first line of defense against airborne particles and microbes and are key to maintaining pulmonary immune homeostasis. There is increasing evidence suggesting that macrophages also participate in the pathogenesis of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), including the modulation of inflammatory responses and the repair of damaged lung tissues. The diversity of their functions may be attributed to their polarized states. Classically activated or inflammatory (M1) macrophages and alternatively activated or anti-inflammatory (M2) macrophages are the two main polarized macrophage phenotypes. The precise regulatory mechanism of macrophage polarization is a complex process that is not completely understood. A growing body of literature on immunometabolism has demonstrated the essential role of immunometabolism and its metabolic intermediates in macrophage polarization. In this review, we summarize macrophage polarization phenotypes, the role of immunometabolism, and its metabolic intermediates in macrophage polarization and ALI/ARDS, which may represent a new target and therapeutic direction.

Previous studies have suggested that DNA double-strand break (DSB) repair is an important protective pathway after damage. The ataxia telangiectasia mutated (ATM) gene plays an important role in the DNA DSB repair pathway. DNA damage is a major cytotoxic effect that can be caused by radiation, and the ability to repair DNA after damage varies among different tissues. Impaired DNA repair pathways are associated with high sensitivity to radiation exposure. Hence, ATM gene polymorphisms are thought to influence the risk of cancer and radiation-induced pneumonitis (RP) risk in cancer patients treated with radiotherapy. However, the results of previous studies are inconsistent. We therefore conducted this comprehensive meta-analysis. A systematic literature search was performed in the PubMed, Embase, China National Knowledge Internet (CNKI) and Wanfang databases to identify studies that investigated the association between the ATM gene polymorphisms and both lung cancer and RP radiotherapy-treated lung cancer (the last search was conducted on Dec.10, 2015). The odds ratio (OR) and 95% confidence interval (CI) were used to investigate the strength of these relationships. Funnel plots and Begg’s and Egger’s tests were conducted to assess the publication bias. All analyses were performed in STATA 13.0 software. Ten eligible case-control studies (4731 cases and 5142 controls) on lung cancer susceptibility and four (192 cases and 772 controls) on RP risk were included. The results of the overall and subgroup analyses indicated that in the ATM gene, the rs189037 (−111G > A, −4519G > A), rs664677 (44831C > T, 49238C > T) and rs664143 (131,717 T > G) polymorphisms were significantly associated with lung cancer susceptibility (OR = 1.21, 95% CI = 1.04–1.39, P = 0.01; OR = 1.26, 95% CI = 1.06–1.49, P = 0.01; OR = 1.43, 95% CI = 1.15–1.78, P < 0.01). Additionally, the rs189037 variant was significantly associated with RP risk (OR = 1.74, 95% CI = 1.02–2.97, P = 0.04). No publication bias was found in the funnel plots, Begg’s tests or Egger’s tests. The results indicate that the ATM rs189037, rs664677 and rs664143 gene polymorphisms are risk factors for lung cancer, while the ATM rs189037 variant was significantly associated with RP risk.

Sarcoidosis is still a rare disease in the epidemic areas of tuberculosis in Western China. This study retrospectively analyzed the characteristics and prognosis of sarcoidosis patients diagnosed in our hospital from January 2012 to December 2018. Finally, 101 patients with sarcoidosis (71 females and 30 males) were included. The age of patients was 46.01 ± 11.24 years. The main symptoms were cough (62.4%), dyspnea (26.7%), chest tightness (15.8%), chest pain (15.8%) and fatigue (10.9%). According to radiologic staging, patients were mainly in stage 1 (39.6%) and stage 2 (48.5%). There were 20 patients (19.8%) with extrapulmonary sarcoidosis, and 52 patients (51.5%) were treated with corticosteroids or immunosuppressants. According to the CT results, patients were divided into two groups: improvement or stable group (Group 1, n=83) and deterioration group (Group 2, n=18). The results showed that patients in the Group 2 had lower levels of blood lymphocyte (p=0.026), Immunoglobulin A (IgA) (p= 0.015) and IgE (p=0.007). The FVC/predict in Group 2 was lower than that in Group 1 (p=0.038), but all were higher than 80%. Interestingly, we found a statistical difference in staging between the two groups, with patients in the Group 2 more in stages 3 and 4 (p=0.006). It is worth noting that 16 patients were treated with antituberculosis drugs in the past, and other 4 cases who failed to receive corticosteroid therapy after diagnosing sarcoidosis, and then were effectively treated with antituberculosis drugs. In summary, this study suggested that decrease of lymphocyte and immunoglobulin and stage of radiology may be related to sarcoidosis deterioration.