Our Summary

Inflammatory diseases, like asthma and chronic rhinosinusitis (a long-term sinus infection), often come back even after treatment. This is partly due to certain immune cells, known as T cells, that remember and react to specific triggers causing inflammation. In this study, the researchers looked at nasal polyps (growths in the nose that can occur with chronic sinus infection) and found that certain T cells that ‘remember’ the inflammation were present when the disease came back. These T cells produce a protein called Granzyme K (GZMK), which activates a part of the immune response that can lead to more inflammation. The presence of this protein was a better predictor of the severity of disease and related conditions than other known markers. In experiments with mice, these GZMK-producing T cells worsened asthma symptoms, but getting rid of GZMK or blocking its function improved lung health. This suggests that GZMK could be a new target for treatments of these types of chronic inflammatory diseases.

FAQs

  1. What are the T cells that ‘remember’ inflammation and how do they relate to nasal polyps?
  2. What is the protein Granzyme K (GZMK) and how does it contribute to inflammation?
  3. Could GZMK be a potential new target for treatments of chronic inflammatory diseases such as asthma and chronic rhinosinusitis?

Doctor’s Tip

After nasal polyp removal, it is important to follow up with your doctor regularly to monitor for any signs of recurrence. It may also be helpful to discuss with your doctor about potential treatments or medications that target specific immune cells, like T cells producing Granzyme K, to help prevent inflammation and reduce the risk of the disease coming back. Be sure to maintain good nasal hygiene and follow any post-operative care instructions provided by your doctor to ensure a smooth recovery and minimize the risk of complications.

Suitable For

Patients who have chronic rhinosinusitis with nasal polyps that do not respond well to other treatments, such as nasal corticosteroids or antibiotics, are typically recommended for nasal polyp removal. These patients may have symptoms such as difficulty breathing through the nose, loss of smell or taste, facial pressure or pain, and persistent nasal congestion.

In addition, patients with severe asthma that is not well-controlled despite medication therapy may also be recommended for nasal polyp removal. Nasal polyps can contribute to worsening asthma symptoms by causing inflammation in the airways and sinus cavities, leading to increased mucus production and difficulty breathing.

Overall, patients who have significant nasal polyp-related symptoms and have not had success with other treatments may benefit from nasal polyp removal to improve their quality of life and reduce the risk of complications from chronic inflammation in the sinuses and airways.

Timeline

  • Before nasal polyp removal:
  1. Patient experiences symptoms of chronic rhinosinusitis, such as nasal congestion, facial pain, and loss of smell.
  2. Patient undergoes diagnostic tests, such as a CT scan or nasal endoscopy, to confirm the presence of nasal polyps.
  3. Patient may undergo various treatments, such as nasal corticosteroids, antibiotics, or nasal irrigation, to manage symptoms and reduce inflammation.
  • After nasal polyp removal:
  1. Patient undergoes nasal polyp removal surgery, either through endoscopic sinus surgery or traditional open surgery.
  2. Patient may experience some discomfort and nasal congestion immediately after the surgery.
  3. Patient will be prescribed medications, such as nasal corticosteroids or antibiotics, to prevent infection and promote healing.
  4. Patient will have follow-up appointments with their surgeon to monitor healing and manage any post-operative complications.
  5. Patient may experience improvement in symptoms, such as reduced nasal congestion and improved sense of smell, following the removal of nasal polyps.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with nasal polyp removal surgery?
  2. What is the success rate of nasal polyp removal surgery in terms of preventing the growth of new polyps?
  3. How long is the recovery process after nasal polyp removal surgery?
  4. Will I need to take any medications or undergo additional treatments after the surgery to prevent the recurrence of nasal polyps?
  5. Are there any lifestyle changes or home remedies that can help reduce the risk of nasal polyp recurrence?
  6. How often should I follow up with you after the surgery to monitor my condition?
  7. Are there any specific symptoms or signs I should watch out for that may indicate the recurrence of nasal polyps?
  8. Can you explain how the presence of GZMK-producing T cells may impact the recurrence of nasal polyps in my case?
  9. Are there any new treatments or therapies targeting GZMK that I should consider for managing my chronic inflammatory disease?
  10. How can I best manage my asthma and chronic rhinosinusitis in conjunction with the removal of nasal polyps?

Reference

Authors: Lan F, Li J, Miao W, Sun F, Duan S, Song Y, Yao J, Wang X, Wang C, Liu X, Wang J, Zhang L, Qi H. Journal: Nature. 2025 Feb;638(8050):490-498. doi: 10.1038/s41586-024-08395-9. Epub 2025 Jan 15. PMID: 39814882