Identification of a distinct glucocorticosteroid-insensitive pulmonary macrophage phenotype in patients with chronic obstructive pulmonary disease

J Allergy Clin Immunol. 2014 Jan;133(1):207-16.e1-11. doi: 10.1016/j.jaci.2013.08.044. Epub 2013 Oct 28.


Background: In patients with chronic obstructive pulmonary disease (COPD), pulmonary macrophages increase in number, release increased levels of inflammatory mediators, and respond poorly to glucocorticosteroids. Whether this is due to a change in macrophage phenotype or localized activation is unknown.

Objective: We sought to investigate whether macrophages from patients with COPD are a distinct phenotype.

Methods: Macrophage populations were isolated from human lung tissue from nonsmokers, smokers, and patients with COPD by using Percoll density gradients. Five macrophage populations were isolated on the basis of density (1.011-1.023, 1.023-1.036, 1.036-1.048, 1.048-1.061, and 1.061-1.073 g/mL), and cell-surface expression of CD14, CD16, CD163, CD40, and CD206 was assessed by using flow cytometry. Release of active matrix metalloproteinase 9, TNF-α, CXCL8, and IL-10 was measured by using ELISA.

Results: The 2 least dense fractions were more than 90% apoptotic/necrotic, with the remaining fractions greater than 70% viable. Macrophages from nonsmokers and smokers were CD163(+), CD206(+), CD14(+), and CD40(-), whereas macrophages from patients with COPD were less defined, showing significantly lower expression of all receptors. There were no differences in receptor expression associated with density. Macrophages from patients with COPD of a density of 1.036 to 1.048 g/mL released higher levels of active matrix metalloproteinase 9 compared with cells from nonsmokers, with no difference between the remaining fractions. This population of macrophages from patients with COPD was less responsive to budesonide compared with those from nonsmokers and smokers when stimulated with LPS. Glucocorticosteroid insensitivity was selective for proinflammatory cytokines because budesonide inhibition of LPS-stimulated IL-10 release was similar for all macrophages.

Conclusions: This study identifies a specific macrophage phenotype in the lungs of patients with COPD who are glucocorticosteroid insensitive with a density of 1.036 to 1.048 g/mL but do not correspond to the current concept of macrophage phenotypes.

Keywords: APC; Allophycocyanin; CD163; CD206; COPD; Chronic obstructive pulmonary disease; EC(50); FITC; Fluorescein isothiocyanate; MFI; MMP; Matrix metalloproteinase; Matrix metalloproteinase 9; Median effective concentration; Median fluorescence intensity; PE; PerCP; Peridinin-chlorophyll-protein; Phycoerythrin; flow cytometry.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, CD / metabolism*
  • Budesonide / pharmacology
  • Budesonide / therapeutic use
  • Cell Separation
  • Drug Resistance
  • Female
  • Flow Cytometry
  • Humans
  • Immunophenotyping
  • Interleukin-10 / metabolism*
  • Interleukin-8 / metabolism
  • Macrophages, Alveolar / drug effects
  • Macrophages, Alveolar / immunology*
  • Male
  • Matrix Metalloproteinase 9 / metabolism
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / immunology*
  • Tumor Necrosis Factor-alpha / metabolism


  • Antigens, CD
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Budesonide
  • Matrix Metalloproteinase 9