Progressive γδ T cell remodelling is associated with type-2 inflammation in eosinophilic chronic rhinosinusitis with nasal polyps.

INTRODUCTION

Eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) is a type-2 inflammatory endotype characterised by tissue eosinophilia and mucosal remodelling. γδ T cells are tissue-resident lymphocytes involved in barrier immunity, yet their subset composition and relationship to inflammatory remodelling in eCRSwNP remain incompletely defined.

METHODS

γδ T cell subsets were analysed in nasal mucosa and polyp tissue from patients with eCRSwNP (n=21) and control subjects (n=10). Mononuclear cells isolated from nasal polyps and middle turbinate mucosa were examined by flow cytometry to quantify Vδ1+Vδ2-, Vδ1-Vδ2+ and Vδ1-Vδ2- subsets. Targeted transcriptional analyses using RT-qPCR assessed expression of TRDV1, TRDV2 and type-2 inflammatory markers. Clinical indices included symptom scores, radiologic disease severity and histological eosinophilia.

RESULTS

eCRSwNP was associated with marked numerical and compositional remodelling of mucosal γδ T cells. Diseased tissue showed expansion of Vδ1-Vδ2+ and Vδ1-Vδ2- subsets, whereas Vδ1+Vδ2- cell numbers remained stable but declined proportionally within the expanding γδ compartment. These shifts followed a gradient from healthy mucosa to non-lesional tissue and nasal polyps and correlated with increasing disease severity, tissue eosinophilia and tissue-level type-2 inflammatory signatures.

DISCUSSION: Progressive γδ T cell remodeling across the sinonasal mucosa in eCRSwNP is associated with type-2 inflammatory activity, tissue eosinophilia and disease severity.