The elongated ciliated cells derived from nasal polyps are distinctly different from ciliated cells in different parts of the nasal mucosa

BACKGROUND: Ciliary abnormalities are implicated in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP), but whether these changes are site-specific traits or confined to specific cell populations remains unknown. Here, we systematically examined ciliated cells throughout the sinonasal tract to characterize disease-specific ciliary alterations and identify a distinct population of elongated ciliated cells in nasal polyps (NPs). METHODS: Nasal biopsy specimens were obtained from patients with CRSwNP (n=32) and non-CRSwNP (n=22). hNECs were differentiated at the air-liquid interface (ALI). Tissue sections, cytospin preparations, and ALI cultures were immunostained for α-tubulin. Cilia length, length of horizontal axis, and length of vertical axis of ciliated cells were recorded. RESULTS: Cilia length was significantly greater in CRSwNP patients than in non-CRSwNP controls (8.17 ± 3.35 μm vs. 5.67 ± 1.64 μm). Within NPs tissues, we identified a distinct population of elongated ciliated cells (ECCs) exhibiting marked inner/outer cilia length disparity, with outer cilia reaching up to 20.0 μm. These ECCs accounted for 8.10% ± 3.56% of total ciliated cells in NPs. Notably, ECCs-like cells were also detected in polypoid-transformed mucosa adjacent to NPs and persisted after ALI culture. In contrast, ciliated cell dimensions did not differ between groups or across the nasal anatomical sites examined. CONCLUSION: A population of ciliated cells characterized by abnormally elongated cilia and concomitant impairment of ciliary function can be found in NPs, which may represent a key pathogenic factor in the development and progression of CRSwNP.