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This study aimed to define the cellular and structural programs that characterize these two inflammatory states and link epithelial, immune, and stromal alterations. Tissue and blood samples from forty-one patients, including twelve with acute cholecystitis and twenty-nine with chronic cholelithiasis, were analyzed using histopathology, immunohistochemistry, transmission electron microscopy, targeted cytokine expression analysis, and single-cell RNA sequencing of immune-enriched suspensions. Acute cholecystitis showed epithelial disruption, edema, and dense infiltration by neutrophils and macrophages, including an increased density of CD163\n                    <jats:sup>+<\/jats:sup>\n                    macrophages, accompanied by elevated systemic inflammation. Chronic cholelithiasis displayed preserved epithelial continuity, fibrosis, glandular remodeling, and reduced immune-cell density. Ultrastructural analysis revealed abundant mucin granules and intact junctions in acute inflammation, contrasting with mucin depletion and dense-body accumulation in chronic disease. Single-cell transcriptomic analysis identified twelve immune and stromal populations, showing contrasting immune\u2013stromal configurations: pro-inflammatory myeloid and cytotoxic T cells dominated in acute inflammation, whereas macrophage\u2013B-cell\u2013fibroblast networks were enriched in chronic cholelithiasis, reflecting adaptive and fibrotic remodeling rather than a temporal transition. This study defines distinct but coordinated immune\u2013stromal programs underlying human gallbladder inflammation and provides a cellular framework for understanding condition-specific mechanisms of acute and chronic disease.\n                  <\/jats:p>","DOI":"10.1007\/s00441-026-04057-6","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:46:44Z","timestamp":1772671604000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Histological, ultrastructural, and single-cell profiling reveal immune-mediated remodeling in gallbladder inflammation"],"prefix":"10.1007","volume":"403","author":[{"given":"Dmytro","family":"Vlasenko","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Maccagno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriano","family":"Sanna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Papadakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanjid Ahmed","family":"Shiplu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"G\u00e4rtner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"M\u00e4rkl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Keshavarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"4057_CR1","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1007\/BF01900817","volume":"25","author":"R Baur","year":"1969","unstructured":"Baur R (1969) [On estimation of the smallest permissible random sample size for stereologic measurements on histologic sections]. 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