There is growing appreciation for the potential role of defective clearance of apoptotic
cells by macrophages in disease pathogenesis. This has naturally lead to the consideration that
therapies directed towards improving phagocytosis may have therapeutic utility. Some of these
candidate therapies are already in use, although their initial rationale was for reasons other than
improving phagocytosis. Examples are macrolide antibiotics, which are known to have antiinflammatory
activities beyond their antimicrobial roles. In certain conditions (panbronchiolitis)
these agents have become first-line therapy. Subsequent studies have revealed that at least part of
their beneficial effects may be mediated via improvements in macrophage function. Statins and
glucocortocosteroids also appear to act in part via improved phagocytosis. More recently, strategies
are being pursued that are more specifically directed towards macrophage function, such as the use
of mannose-binding lectin, but the initial rationale was to improve phagocytosis of microorganisms
– the potential role in effercytosis has been realised subsequently. We have conducted a
number of human and animal studies which support the potential role for improving phagocytosis as
a therapeutic strategy for airways disease. A number of new strategies are emerging which show
clinical promise.