Research Progress on Non-Coding RNA-Mediated Macrophage Polarization in Chronic Obstructive Pulmonary Disease

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disorder characterized by remarkable heterogeneity. Its pathogenesis involves inflammatory responses, oxidative stress, protease-antiprotease imbalance, and immune dysregulation. Recent studies have demonstrated that macrophages, as key components of the innate immune system, play a pivotal regulatory role in COPD pathogenesis through phenotypic polarization. Non-coding RNAs (ncRNAs) serve as critical regulatory factors that can finely orchestrate macrophage polarization and functional states through diverse mechanisms, including post-transcriptional gene silencing, chromatin remodeling, and competing endogenous RNA (ceRNA) networks, thereby influencing the inflammatory processes and pathological progression of COPD. METHODS AND RESULTS: This review comprehensively searched for domestic and international literature on macrophage polarization, ncRNAs, and COPD, and analyzed and summarized the relevant content. This article mainly discussed macrophage polarization in COPD, analyzed the regulatory roles of different ncRNA subtypes in macrophage M1/M2 polarization, the molecular mechanisms by which ncRNAs participate in the development and progression of COPD through regulating macrophage polarization, and evaluated the value of ncRNAs targeting macrophage polarization as potential biomarkers for COPD, as well as the prospects and challenges of ncRNA-targeted therapy for COPD. CONCLUSION: This review summarizes the current research progress on ncRNAs regulating macrophage polarization in COPD, with the aim of deepening the understanding of the underlying molecular mechanisms, identifying novel biomarkers for disease diagnosis, subtyping, and prognostic assessment, reviewing ncRNA-targeted therapeutic strategies, exploring precise regulation centered on the ncRNA-macrophage polarization axis, and providing new insights for personalized diagnosis and treatment of COPD.