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  3. Cigarette smoke-induced epithelial cell ferroptosis promotes neutrophilic inflammation in patients with nasal polyps

Cigarette smoke-induced epithelial cell ferroptosis promotes neutrophilic inflammation in patients with nasal polyps

  • J Allergy Clin Immunol. 2025 Mar 12:S0091-6749(25)00266-0. doi: 10.1016/j.jaci.2025.02.034.
Li Pan 1,  Ze Yu 1,  Wen-Xuan Xiang 2,  Shi-Ran Sun 2,  Jing-Xian Li 1,  Yi-Ke Deng 1,  Meng-Chen Wang 1,  Ji-Xin Zhong 3,  Kun Huang 4,  Pei-Song Gao 5,  Li-Ping Zhu 6,  Yin Yao 7,  Zheng Liu 8
Affiliations

Affiliations

  • 1 Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China.
  • 2 Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • 3 Department of Rheumatology and Immunology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China; Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • 4 School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • 5 Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Md.
  • 6 Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • 7 Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China; Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: dr.yaoyin@hotmail.com.
  • 8 Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Clinical Research Center for Nasal Inflammatory Diseases, Wuhan, China; Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Otorhinolaryngology-Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China. Electronic address: zhengliuent@hotmail.com.
PMID: 40086488 DOI: 10.1016/j.jaci.2025.02.034
Abstract

Background: Regulation of epithelial cell death has emerged as a key mechanism maintaining immune homeostasis in the airway. However, the mechanisms governing epithelial cell survival in nasal polyps (NPs) remain poorly understood.

Objective: We sought to investigate the Ferroptosis of nasal epithelial cells and its implications in the pathogenesis of NPs.

Methods: The cell death, lipid peroxidation, and ferrous iron levels in nasal epithelial cells were determined by flow cytometry. Biomarkers and signaling pathways associated with Ferroptosis were evaluated by quantitative RT-PCR, single-cell and bulk RNA Sequencing, immunofluorescence staining, and Western blotting. Human nasal epithelial cells (HNECs) and human bronchial epithelial cells (16HBE) were stimulated with different agents. Mitochondrial ultrastructure in HNECs was visualized by transmission electron microscopy. Cytokine levels were quantified using ELISA. A cigarette smoke extract (CSE)-induced mouse model was established and treated with deferoxamine.

Results: Nasal epithelial cells from both eosinophilic and noneosinophilic NPs showed intensified lipid peroxidation and altered mitochondrial morphology, resembling the features of Ferroptosis. Ferroptosis triggered CXCL8 production in 16HBE cells and HNECs through the activation of mitogen-activated protein kinase pathway. CSE exposure elevated ferrous iron levels by upregulating Transferrin Receptor 1, leading to Ferroptosis and subsequent CXCL8 production in HNECs. Deferoxamine treatment inhibited nasal epithelial cell Ferroptosis, CXCL8 levels, and neutrophil numbers in a CSE-induced mice model. Smoking burden was correlated with CXCL8 levels and neutrophil infiltration in patients with NPs. An analysis of 494,176 UK Biobank participants revealed smoking as a risk factor for NPs (odds ratio, 1.346; 95% CI, 1.245-1.456; P < .001).

Conclusions: Smoking-induced Ferroptosis promotes CXCL8 production in nasal epithelial cells and thus potentially exacerbates neutrophilic inflammation in NPs.

Keywords

Ferroptosis; nasal epithelial cell; nasal polyps; neutrophil; smoking.

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