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Recent studies have characterized various mouse antigen-presenting cells (APCs) expressing the lymphoid-lineage transcription factor RORγt (Retinoid-related orphan receptor gamma t), which exhibit distinct phenotypic features and are implicated in the induction of peripheral regulatory T cells (Tregs) and immune tolerance to microbiota and self-antigens. These APCs encompass Janus cells and Thetis cell subsets, some of which express the AutoImmune REgulator (AIRE). RORγt+ MHCII+ type 3 innate lymphoid cells (ILC3) have also been implicated in the instruction of microbiota-specific Tregs. While RORγt+ APCs have been actively investigated in mice, the identity and function of these cell subsets in humans remain elusive. Herein, we identify a rare subset of RORγt+ cells with dendritic cell (DC) features through integrated single-cell RNA sequencing and single-cell ATAC sequencing. These cells, which we term RORγt+ DC-like cells (R-DC-like), exhibit DC morphology, express the MHC class II machinery, and are distinct from all previously reported DC and ILC3 subsets, but share transcriptional and epigenetic similarities with DC2 and ILC3. We have developed procedures to isolate and expand them in vitro, enabling their functional characterization. R-DC-like cells proliferate in vitro, continue to express RORγt, and differentiate into CD1c+ DC2-like cells. They stimulate the proliferation of allogeneic T cells. The identification of human R-DC-like cells with proliferative potential and plasticity toward CD1c+ DC2-like cells will prompt further investigation into their impact on immune homeostasis, inflammation, and autoimmunity. [ABSTRACT FROM AUTHOR]

The article describes the case of ear, nose, throat (ENT) and airways disease in granulomatosis with polyangiitis (GPA) in a female patient in her late 20s. Topics discussed include the symptoms of the patient upon presentation including vasculitic rash, nasal crusting, bloody nasal discharge and facial pain, effect of cyclophosphamide and rituximab on her lung cavity, and importance of an ENT assessment within 24 to 48 hours to patients with acute or subacute hearing loss.

ENT involvement is common in ANCA‐associated vasculitis (AAV), particularly in GPA and EGPA. Early recognition and treatment is important for good outcomes, yet evidence suggests that UK ENT surgeons may not consistently recognise the early features of AAV, despite a similar incidence to vestibular schwannoma. AAV is a rapidly advancing field, with significant developments in the understanding of its pathogenesis, classification and treatment over the past decade. Relevant vasculitis mimics are also discussed with a particular focus on the increasing prevalence of vasculitis mimics driven by an increase in recreational cocaine use, as well as the emergence and reclassification of several other vasculitis mimics in the head and neck. This article reviews key recent updates in the vasculitis literature, with a particular focus on those relevant to recognition and diagnosis of AAV for the ENT surgeon. Strengths and limitations of relevant diagnostic testing are discussed, and a method of evaluation of patients with features of AAV presenting to ENT services is outlined. [ABSTRACT FROM AUTHOR]

Developing an innovative office-based UK rhinology service - Experience and outcomes in 22 patients undergoing office-based local anaesthetic nasal polypectomy In addition to SNOT-22, patients were asked in the first postoperative questionnaire (15 days) about the presence and severity of side effects which are commonly encountered by patients after endoscopic nasal polypectomy under GA. Figure shows SNOT-22 scores by patient; for the one-year cohort, 12/15 patients (80%) had equal or improved SNOT-22 scores at one year, when compared to three-month scores. We have demonstrated beneficial outcomes of office-based nasal polypectomy in a small group of patients over a 1-year period both in terms of patient-reported outcomes and patient expectations. [Extracted from the article]