Autophagy is a homeostatic process common to all eukaryotic cells that serves to degrade intracellular components. Among three classes of autophagy, macroautophagy is best understood, and is the subject of this Review. The function of autophagy is multifaceted, and includes removal of long-lived proteins and damaged or unneeded organelles, recycling of intracellular components for nutrients, and defense against pathogens. This process has been extensively studied in yeast, and understanding of its functional significance in human disease is also increasing. This Review explores the basic machinery and regulation of autophagy in mammalian systems, methods employed to measure autophagic activity, and then focuses on recent discoveries about the functional significance of autophagy in respiratory diseases, including chronic obstructive pulmonary disease, cystic fibrosis, tuberculosis, idiopathic pulmonary fibrosis, pulmonary arterial hypertension, acute lung injury, and lymphangioleiomyomatosis.Keywords: autophagy; chronic obstructive pulmonary disease; idiopathic pulmonary fibrosis; epithelial cells; fibroblasts Autophagy is an evolutionarily conserved process first described more than 50 years ago that is vital to cellular homeostasis. Many of the molecular events and pathways involved in autophagy were discovered in yeast cells, but knowledge of its function and regulation in mammalian systems has increased greatly in the last decade. Best studied in cancer and neurodegenerative diseases, its role in respiratory diseases is becoming increasingly important with each passing year. To date, it has been studied in chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, cystic fibrosis (CF), pulmonary arterial hypertension (PAH), tuberculosis, acute lung injury, and lymphangioleiomyomatosis. This Review first focuses on the basic mechanisms and regulation of autophagy, as well as the various techniques employed in its measurement in cells and tissues. We then turn to the functional significance of autophagy in the aforementioned respiratory diseases (Table 1). Given the cell-and environmentdependent nature of autophagy, the discussion of these diseases here are within the context of the major respiratory cell types. Continued elucidation of the functional role of autophagy in these lung diseases and others will allow better understanding of their pathophysiologic underpinnings and offer potential new diagnostic and/or therapeutic targets.
CLASSES OF AUTOPHAGYThe term autophagy, derived from the Greek and meaning "self eating," comprises three related but distinct cellular processes that entail delivery of cytoplasmic components to lysosomes for degradation and recycling. Microautophagy involves nonselective envelopment of cytoplasmic components directly by lysosomes. Chaperone-mediated autophagy consists of selectively transporting cargo tagged by a pentapeptide motif to the lysosome, binding to lysosomal receptors, and translocation across the membrane. The third category of autophagy is macroautophagy. Th...