10.14639/0392-100X-N1813
text/xml
1827-675X
1813
en
Mariola Popko-Zagor
http://creativecommons.org/licenses/by-nc-nd/4.0
ACTA Otorhinolaryngologica Italica
T cell exhaustion
Immune system elements - a puzzle in CRS
Text.Serial.Journal
https://www.actaitalica.it/
42
Letters to the Editor-in-Chief
2022-05-16
2021-09-09
2022-05-23
2022-05-23
194-196
1
Mariola Popko-Zagor
2022/05/16
10.14639/0392-100X-N1813
194
ENT-Department, Czerniakowski Hospital, Warsaw, Poland
1827-675X
T cell exhaustion
en
196
Immune system elements - a puzzle in CRS
https://www.actaitalica.it/article/download/1813/806
42
ACTA OTORHINOLARYNGOLOGICA ITALICA 2022;42:194-196; doi: 10.14639/0392-100X-N1813




Letter to the Editor


Immune system elements - a puzzle in CRS
Elementi del sistema immunitario - un puzzle nella rinosinusite cronica
Katarzyna Kowalik1, Elżbieta Sarnowska2, Tomasz J. Sarnowski3, Mariola Popko-Zagor4
1
 ENT-Department, Hospital in Sanok, Sanok, Poland; 2 Department of Experimental Immunotherapy, Maria Sklodowska-Curie
National Research Institute of Oncology , Warsaw, Poland; 3 Institute of Biochemistry and Biophysics Polish Academy of Sciences,
Warsaw, Poland; 4 ENT-Department, Czerniakowski Hospital, Warsaw, Poland


KEY WORDS: chronic rhinosinusitis, SWI/SNF complex, T cell exhaustion

PAROLE CHIAVE: rinosinusite cronica, complesso SWI/SNF, esaurimento delle cellule T


Dear Editor,
We read with great interest and appreciated the comments by Gelardi et al. to
our paper entitled “The SWI/SNF complex in eosinophilic and non-eosino-
philic chronic rhinosinusitis” 1. In their Letter “Should the role of mast cells
in chronic rhinosinusitis with nasal polyps be revaluated?”, Gelardi et al. 2
pointed out a very important issue related to chronic rhinosinusitis (CRS),
namely the role of mast cells (MCs) in chronic rhinosinusitis with nasal polyps
(CRSwNP). Mast cells have been reported in the pathophysiology of diseases
like asthma, allergy, skin diseases, gastrointestinal disorders and various ma-
lignancies as well as cardiovascular disease 1. MCs associated with eosino-
phils play a complex role, sometimes distinct and sometimes complementary,
depending on the context 2. Interestingly, mast cells can present antigens and
modulate T cell response 3, and tumour-associated mast cells have immuno-
suppressive function in the tumour microenvironment. Apart from the broad
                                                                                       Received: September 9, 2021
repertoire of diseases involving their action, MCs, when activated, may pro-           Accepted: November 8, 2021
mote eosinophilic inflammation in chronic rhinosinusitis with nasal polyps.
Thus, we fully agree with Gelardi et al. that scientific attention in CRS should       Correspondence
be given to the role of MCs. We additionally postulate that the role of other          Katarzyna Kowalik
                                                                                       ENT-Department, Hospital in Sanok, 800-lecia 26,
immune cells like macrophages, NK, dendritic, and T and B cells 4 should               38-500 Sanok, Poland
be evaluated more carefully in CRS, although the current EPOS 2020 guide-              Tel. +48 603273950
lines sub-classify CRS based on the eosinophil infiltration as non-eosinophilic        E-mail: katarzyna.stanska@gmail.com
(neCRS) or eosinophilic (eCRS) 5. In our paper, we followed the classifica-
tion and found a negative correlation between SWI/SNF subunit abundance in               How to cite this article: Kowalik K, Sarnow-
                                                                                         ska E, Sarnowski TJ, et al. Immune system
the epithelium and eosinophil count, thus supporting the role of SWI/SNF in              elements - a puzzle in CRS. Acta Otorhi-
eCRS 6. We are, however, fully aware of the fact that our study represents only          nolaryngol Ital 2022;42:194-196. https://doi.
a part of a broader picture of changes characteristic for CRS.                           org/10.14639/0392-100X-N1813
It has been described that epithelial to mesenchymal transition (EMT) is as-
                                                                                       © Società Italiana di Otorinolaringoiatria
sociated with CRSwNP. Moreover, the Wnt signaling pathway is involved                  e Chirurgia Cervico-Facciale
in nasal polyp pathogenesis via EMT 7. SWI/SNF impairment, namely the
loss of SMARCB1/INI1, a core SWI/SNF complex subunit, has been linked                                 OPEN ACCESS
with activation of the Wnt signaling pathway 8. The SWI/SNF complex is in-             This is an open access article distributed in accordance with
                                                                                       the CC-BY-NC-ND (Creative Commons Attribution-Non-
volved in epigenetic control of gene expression and plays an important role            Commercial-NoDerivatives 4.0 International) license. The
in the response of upper airway epithelial cells to infections. Deficiency of          article can be used by giving appropriate credit and mentio-
                                                                                       ning the license, but only for non-commercial purposes and
the SMARCA4/BRG1 central ATPase subunit disrupts function of the SWI/                  only in the original version. For further information: https://
SNF complex and triggers a hybrid epithelial/mesenchymal state which may               creativecommons.org/licenses/by-nc-nd/4.0/deed.en




194
                                                                                 Potential role of SWI/SNF in immune system cells in CRS




Figure 1. The role of SWI/SNF in immune cell function.


lead to tissue remodeling upon RSV infection 9. The SWI/        not least, since the SWI/SNF complex plays an important
SNF complex is also involved in inflammation and immune         role in the eviction of the Polycomb Repressive Complex
response. Furthermore, we recently found that SWI/SNF           2, another epigenetic machinery involved in the control of
chromatin remodeling complex plays a crucial role in CD4+       gene expression, evaluation of the potential role of EZH2
T cell exhaustion mediated by cancer cells 10. T cell exhaus-   (central PRC2 subunit) in CRS seems to be vital because it
tion is well documented in chronic infections and leads to      may open the possibility of the use of epidrugs in CRSwNP
T cell dysfunction. Therefore, in view of our unpublished       treatment.
data and currently available knowledge, we postulate that
in precision medicine of CRSwNP not only the role of eo-        Conflict of interest statement
sinophils should be assessed, but also other types of im-       The authors declare no conflict of interest.
mune cells need to be taken into the consideration.
In our opinion, the substantially broader picture of CRS        Funding
will be constructed only if potential links between SWI/        This research did not receive any specific grant from fund-
SNF alterations and the role of other immune cells will         ing agencies in the public, commercial, or not-for-profit
be evaluated. The extent of the SWI/SNF complex should          sectors.
likely be tested in both nasal epithelium and immune cells.
Thus, in agreement with Gelardi et al. suggestions, we          Authors’ contributions
highlight the following potential directions which should       All authors contributed equally.
be taken into consideration in further study of CRS: i) in-
vestigation of the extent of T cell exhaustion in CRS; ii)
                                                                References
assessment of the role of mast cells and other immune cells
                                                                1
                                                                    Kowalik K, Waniewska-Leczycka M, Sarnowska E, et al. The SWI/
in CRS-associated immune response and inflammation; iii)
                                                                    SNF complex in eosinophilic and non eosinophilic chronic rhinosi-
correlation of the SWI/SNF aberrations with epithelial cells        nusitis. Acta Otorhinolaryngol Ital 2021;41:159-167. https://doi.
and mucosa tissue remodeling observed in CRS. Last, but             org/10.14639/0392-100X-N0760




                                                                                                                                   195
K. Kowalik et al.




2
    Gelardi M, Giancaspro R, Cassano M. Should the role of mast             7
                                                                                 Bae JS, Ryu G, Kim JH, et al. Effects of Wnt signaling on epi-
    cells in chronic rhinosinusitis with nasal polyps be revalu-                 thelial to mesenchymal transition in chronic rhinosinusitis with
    ated? Acta Otorhinolaryngol Ital 2021;41:576-577. https://doi.               nasal polyp. Thorax 2020;75:982-993. https://doi.org/10.1136/
    org/10.14639/0392-100X-N1768                                                 thoraxjnl-2019-213916
3
    Galdiero MR, Varricchi G, Seaf M, et al. Bidirectional mast cell-eo-    8
                                                                                 Wanior M, Krämer A, Knapp S, et al. Exploiting vulnerabilities of SWI/
    sinophil interactions in inflammatory disorders and cancer. Front Med        SNF chromatin remodelling complexes for cancer therapy. Oncogene
    2017;4:103. https://doi.org/10.3389/fmed.2017.00103                          2021;40:3637-3654. https://doi.org/10.1038/s41388-021-01781-x
4
    Bulfone-Paus S, Bahri R. Mast cells as regulators of T cell re-         9
                                                                                 Xu X, Qiao D, Dong C, et al. The SWI/SNF-related, matrix associat-
    sponses. Front Immunol 2015;6:394. https://doi.org/10.3389/                  ed, actin-dependent regulator of chromatin A4 core complex represses
    fimmu.2015.00394                                                             respiratory syncytial virus-induced syncytia formation and subepithe-
5
    Kaczmarek M, Wasicka K, Tin-Tsen Chou J, et al. NK cells in patients         lial myofibroblast transition. Front Immunol 2021;12:633654. https://
    with chronic rhinosinusitis show decreased maturity and limited ex-          doi.org/10.3389/fimmu.2021.633654
    pression of functional receptors. Immunobiology 2020;225:151890.        10
                                                                                 Jancewicz I, Szarkowska J, Konopinski R, et al. PD-L1 Overexpres-
    https://doi.org/10.1016/j.imbio.2019.11.025                                  sion, SWI/SNF complex deregulation, and profound transcriptomic
6
    Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper               changes characterize cancer-dependent exhaustion of persistently ac-
    on rhinosinusitis and nasal polyps 2020. Rhinology 2020;58:1-464.            tivated CD4(+) T cells. Cancers (Basel) 2021;13: 4148. https://doi.
    https://doi.org/10.4193/Rhin20.600                                           org/10.3390/cancers13164148




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