The immune system is an often overlooked contributor to disease in the head and neck.
The goal of the Division of Immunology Research in the Mayo Clinic Department of Otolaryngology — Head and Neck Surgery is to better understand the role of the immune system in the underlying pathophysiology of otorhinolaryngologic diseases.
The immune system's interactions in disease pathobiology are often overlooked, yet they can bring critical insight to disease progression and treatment. In some cases, the connection between the immune system and otorhinolaryngologic disease is readily apparent. For example, the immune system drives chronic rhinosinusitis with nasal polyps.
In other cases, the immune system's role is less apparent. For example, immune cells and the tumor cells that cause head and neck cancers are in a constant battle, with immune cells trying to clear the tumor cells and the tumor cells suppressing the immune response to maintain their survival. In other cases, the immune system can induce side effects that cause treatments to fail, such as granulomas that encase laryngoplasty injections and obstruct breathing.
Immune cells in chronic rhinosinusitis with nasal polyps
Chronic rhinosinusitis is a common, chronic, immune-mediated condition that may be accompanied by nasal polyps. Researchers don't yet fully understand how the immune system interacts with the nasal airway to drive the development of chronic rhinosinusitis and, in particular, the growth of nasal polyps. While some nasal polyps can be treated with topical or oral drugs, others require surgical removal. Unfortunately, polyps can return after surgery, creating a cycle of removal and regrowth.
The Division of Immunology Research in the Department of Otolaryngology — Head and Neck Surgery is working with the department's rhinology and skull base surgery experts to understand the role of immune cells in nasal polyp growth, focusing on the interactions between various types of T cells and eosinophils in epithelial tissues. These studies will contribute to the development of new treatments that can intercept immune signals and reduce polyp growth or prevent reemergence.
Immune cells in head and neck cancer
The Division of Immunology Research is working with the Division of Head and Neck Cancer and Reconstructive Surgery to identify which T cell subsets are involved in progression of oropharyngeal squamous cell carcinoma (throat cancer) related to human papillomavirus (HPV).
While HPV-positive tumors are generally highly responsive to treatment, a subset of patients experience recurrence of the tumor. Using data-rich high-dimensional techniques such as mass cytometry by time-of-flight (CyTOF) and imaging mass cytometry (Hyperion), researchers are seeking to understand differences in response to treatment.
Knowing which immune cells are involved in cancer and how they interact with each other and with tumor cells can lead to more effective ways to treat the cancer.
Immune cells in treatment of vocal cord paralysis
Vocal cord paralysis is caused by nerve damage, usually during surgery or as a result of viral infections or certain cancers. The resulting paralysis of vocal cord muscles inhibits the ability to speak and breathe and can also result in aspiration upon swallowing.
Treatment of vocal cord paralysis often includes injection laryngoplasty, in which collagen, adipose tissue or another substance is injected into the paralyzed vocal cord, enabling it to work with the intact cord and restore function. However, immune cells are activated by foreign molecules and may attack the implant, causing it to perform poorly or creating an inflammatory-mediated obstruction to breathing and swallowing.
The Division of Immunology Research is working with surgeons in the Division of Laryngology to identify the nature of the immune response involved and uncover potential pathways for treatments to limit or eliminate inflammation associated with laryngoplasty injections.
Personalized immunology research
Immune responses are highly individualized, with each person's genetics and environmental history shaping their immune profile. Among the factors that influence how the immune system impacts disease are sex as a biological variable, the microbiome, and cross-talk between immune cells and the nervous system. As the division continues to broaden its research scope, researchers will seek to improve the understanding of how these factors impact both mechanisms and treatments of disease.