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Nasal tissue-resident memory T cells may provide a framework for understanding allergic rhinitis relapseNew cellular targets could help manage chronic allergy symptoms

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Key Takeaway
Note that targeting TRM cells and granzyme K may offer a way to address allergic rhinitis relapse.

This mini review examines the role of nasal tissue-resident memory (TRM) cells in the pathophysiology of allergic rhinitis (AR) and chronic rhinosinusitis with nasal polyps (CRSwNP). The authors focus on TRM cells, including Th2-polarized CD4+ subsets and pathogenic CD8+ subsets, as potential cellular substrates for AR chronicity and post-immunotherapy relapse.

Key findings suggest that granzyme K (GZMK)-expressing CD8+ memory T cells drive recurrent airway inflammation. These cells provide a translatable framework for understanding why some patients experience AR relapse. However, the authors note that the role of nasal TRM cells in AR is largely hypothetical and relies on integrated findings from CRSwNP, lower-airway disease, and animal models.

A primary limitation is the lack of direct, high-resolution human evidence for nasal TRM in pure allergic rhinitis. Despite this, the authors suggest that targeting TRM retention, phenotype, or effector molecules could potentially complement current allergen immunotherapy strategies. Clinical application remains preliminary due to the current lack of specific human data in pure AR cases.

How this fits prior evidence

This review addresses a gap in the understanding of allergic rhinitis relapse. While prior evidence confirms that comprehensive-component subcutaneous immunotherapy shows the most favorable symptom score reduction in allergic rhinitis, this review explores cellular mechanisms like TRM cells to address post-immunotherapy relapse. It also relates to the finding that biologics provide effective and long-lasting disease control for chronic rhinosinusitis with nasal polyps, as the review draws on CRSwNP data to hypothesize the role of TRM cells in allergic rhinitis.

Living with chronic allergies or nasal polyps can feel like a constant battle against your own immune system. Even with standard treatments like immunotherapy, some people find their symptoms return over time. Researchers are now looking closer at the specific cells living in the nasal tissue to understand why this happens.

They are focusing on memory T cells. These are immune cells that stay in the nose and can cause ongoing inflammation. Specifically, a type of cell that produces granzyme K is being studied as a potential reason for recurring symptoms. While these findings are based on a mix of human and animal data, they offer a new way to think about why some treatments don't last.

It is important to note that direct evidence in people with only allergic rhinitis is still limited. Much of what we know comes from related conditions like nasal polyps. However, finding ways to target these specific cells could eventually help doctors create more lasting relief for patients who struggle with chronic issues.

What this means for you:
Targeting specific memory T cells in the nose could help prevent allergy symptoms from returning after treatment.

Common questions

Why do some allergy symptoms keep coming back?

Researchers believe certain memory T cells that live in the nasal tissue might be responsible for chronic symptoms and relapses after treatment. These cells can drive ongoing inflammation in the airways, making it harder for the body to stay clear of symptoms.

What are these specific immune cells that cause inflammation?

The study highlights a specific type of cell called granzyme K expressing CD8+ memory T cells. These cells are thought to drive recurring inflammation and provide a framework for understanding why some people experience a relapse after starting immunotherapy.

Is this a proven treatment for allergic rhinitis?

Not yet. The role of these specific cells in allergic rhinitis is currently considered largely hypothetical. Much of the current evidence comes from related conditions and animal models, so more direct human evidence is needed before it can be used as a standard treatment.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Allergic rhinitis (AR) is a pervasive type-2 inflammatory disorder of the nasal mucosa whose clinical course is defined less by acute flares than by recurrence and apparent resistance to cure. Although AR has traditionally been framed as a systemic, IgE-driven disease, a growing body of evidence points to the nasal mucosa itself as a site of durable, antigen-specific immune memory. Tissue-resident memory T (TRM) cells - non-recirculating, longevity-endowed lymphocytes that lodge in barrier tissues - are ideally positioned to convert transient allergen exposure into persistent inflammation. This mini review synthesizes human and preclinical evidence that nasal TRM cells, including Th2-polarized CD4+ subsets and a recently described pathogenic CD8+ subset (first characterized in recurrent chronic rhinosinusitis with nasal polyps, CRSwNP), constitute a credible - but still largely hypothetical - cellular substrate for AR chronicity and post-immunotherapy relapse. We propose that the 2025 discovery of granzyme K (GZMK)-expressing CD8+ memory T cells driving recurrent airway inflammation (Lan et al., Nature 2025) provides a translatable framework for understanding AR relapse. We note that direct, high-resolution human evidence for nasal TRM in pure AR remains limited; accordingly, we integrate findings from CRSwNP, lower-airway disease, and animal models as a translatable evidence base and explicitly flag where each conclusion is established versus hypothetical. We outline how targeting TRM retention, phenotype, or effector molecules could complement allergen immunotherapy.
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