Hyperglycemic milieu impairs Vγ9Vδ2 T cell functions in tuberculosis patients and prolongs M.tb negative conversion time.

γδ T cells play protective roles in tuberculosis (TB). Our work demonstrated the therapeutic potential of allogeneic Vγ9Vδ2 T cells in TB patients. However, their functions in TB require further comprehensive evaluation. Here, we compared γδ T cells in TB patients and healthy adults at the bulk and single-cell RNA and protein levels, revealing that impaired glucose metabolism critically undermines their anti-infective functions. Excessive glucose disrupts γδ T cell effector functions, correlating with prolonged sputum smear conversion time in TB patients with type II diabetes. Additionally, serum glucose levels were linked to multidrug-resistant TB. These findings suggest that weakened Vδ2γδ T cell responses in diabetic TB patients contribute to multidrug resistance. Restoring Vδ2γδ T cell function offers a promising strategy for TB treatment.