Macrophages in the inflammatory response to endotoxic shock

Background Endotoxic shock, particularly prevalent in intensive care units, represents a significant medical challenge. Endotoxin, upon invading the host, triggers intricate interactions with the innate immune system, particularly macrophages. This activation leads to the production of inflammatory mediators such as tumor necrosis factor‐alpha, interleukin‐6, and interleukin‐1‐beta, as well as aberrant activation of the nuclear factor‐kappa‐B and mitogen‐activated protein kinase signaling pathways. Objective This review delves into the intricate inflammatory cascades underpinning endotoxic shock, with a particular focus on the pivotal role of macrophages. It aims to elucidate the clinical implications of these processes and offer insights into potential therapeutic strategies. Results Macrophages, central to immune regulation, manifest in two distinct subsets: M1 (classically activated subtype) macrophages and M2 (alternatively activated subtype) macrophages. The former exhibit an inflammatory phenotype, while the latter adopt an anti‐inflammatory role. By modulating the inflammatory response in patients with endotoxic shock, these macrophages play a crucial role in restoring immune balance and facilitating recovery. Conclusion Macrophages undergo dynamic changes within the immune system, orchestrating essential processes for maintaining tissue homeostasis. A deeper comprehension of the mechanisms governing macrophage‐mediated inflammation lays the groundwork for an anti‐inflammatory, targeted approach to treating endotoxic shock. This understanding can significantly contribute to the development of more effective therapeutic interventions. Understanding the pathophysiology of endotoxic shock, especially the molecular mechanisms of macrophages in the inflammatory response to endotoxic shock, can provide a sound basis for the treatment of endotoxic shock.