Table 2.

Immune-Modulatory Approaches to Delay COPD Airway Remodeling

Immune-Modulatory Approach	Mechanism
Inhaled corticosteroid	ECM deposition↓
	EMT↓
Inflammatory cell infiltration↓
Macrolide	Inflammatory cascade↓
	Adhesion molecule expression↓
	Neutrophil chemotaxis and activation↓
Monocyte-macrophage differentiation↓
Fluoroquinolones	NF-κB activation↓
Ceftaroline	TLR expression↓
Vitamin D receptor	Retain phagocytic capacity
NF-κB and p38 MAPK cascade↓→ MMPs and TGF-β ↓ → airway wall destruction↓ fibrotic repair↓
Antibodies of pro-inflammatory cytokines	IL-4, IL-5, IL-13, and IgE↓

Notes: ↑, increased during COPD progression; ↓, decreased during COPD progression; (-), no change during COPD progression.

Abbreviations: ECM, extracellular matrix; EMT, epithelial-mesenchymal transition; NF-κB, nuclear factor kappa-light-chain-enhancer of activated B cells; TLR, toll-like receptors; p38 MAPK, p38 mitogen-activated protein kinase; MMPs, matrix metalloproteinases; TGF-β, transforming growth factor beta; IL, interleukin; IgE, immunoglobulin E.