Gas exchange
Gas exchange must be restored as quickly as possible to avoid collateral damage, so activated lymphocytes secrete IFNγ to stimulate the production of matrix metalloproteinase MMP-9 by macrophages. AMs have been reported to produce MMP-9 partly via PGE2-dependent PKA signaling pathways, which are the pathways involved in the inhibition of phagocytosis. MMP-9 activates latent TGF-β, reinducing expression of αvβ6 integrins on alveolar epithelial cells, thereby returning the alveolar macrophage to a resting state. Activation of TGF-β is also advantageous because its production stimulates collagen synthesis in interstitial fibroblasts, which is necessary for restoring alveolar wall architecture.