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Brożek-Mądry E, Burska Z, Życińska K, Sierdziński J. Nasal Microbiome in Granulomatosis with Polyangiitis Compared to Chronic Rhinosinusitis. Diagnostics (Basel) 2024; 14:1673. [PMID: 39125549 PMCID: PMC11311696 DOI: 10.3390/diagnostics14151673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/29/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Rhinosinusitis in granulomatosis with polyangiitis (GPA) is categorised as a secondary, diffuse and inflammatory chronic rhinosinusitis (CRS). It is one of the conditions that impacts the nasal microbiota. This study aimed to compare the nasal microbiomes of patients with GPA, CRS and NSP. A total of 31 patients were included in the study (18 GPA, 6 CRS and 7 nasal septum perforation (NSP)). In all patients, SNOT 22, a nasal endoscopy (Lund-Kennedy scale) and a brush swab were performed. The metagenomic analysis was carried out based on the hypervariable V3-V4 region of the 16S rRNA gene. At the genus level, statistically significant differences were observed in two comparisons: the GPA/NSP and the GPA/CRS groups. In the GPA/NSP group, the differences were related to four genera (Actinomyces, Streptococcus, Methylobacterium-Methylorubrum, Paracoccus), while in the GPA/CRS group, they were related to six (Kocuria, Rothia, Cutibacterium, Streptococcus, Methylobacterium-Methylorubrum, Tepidimonas). Patients with GPA had lower diversity compared to CRS and NSP patients. There were no statistically significant differences found for the Staphylococcus family and Staphylococcus aureus between the three groups.
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Affiliation(s)
- Eliza Brożek-Mądry
- Department of Otorhinolaryngology, National Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland
| | - Zofia Burska
- Department of Otorhinolaryngology, National Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland
| | - Katarzyna Życińska
- Department of Rheumatology, Connective Tissue Diseases and Rare Diseases, National Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland
| | - Janusz Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00-581 Warsaw, Poland
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P. P, Sangavi A, U V, Saiyad SN, Chickle B. Nasal Microbiota and Sensitivity Pattern in Rhinosinusitis. Indian J Otolaryngol Head Neck Surg 2024; 76:922-927. [PMID: 38440589 PMCID: PMC10908717 DOI: 10.1007/s12070-023-04321-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 03/06/2024] Open
Abstract
Aims To know the microorganism causing rhinosinusitis & to study the antibiotic sensitivity pattern for the isolated nasal microbiota in this region. Background Rhinosinusitis is inflammatory condition of nose and paranasal sinuses [1]. It is multifactorial condition, in which microorganisms play pathogenic role [2]. Interactions between microorganisms, mucosa and environmental changes influence on composition of bacterial ecosystem [2]. Though antibiotics are frequently used for medical management of rhinosinusitis, sensitivity directed antibiotics are rarely prescribed. So, this study is directed to know microbial isolate in rhinosinusitis and its antibiotic sensitivity pattern. Methodology in this 6 months prospective study during March to September 2022, done at Department of Otorhinolaryngology, Raichur Institute of Medical Sciences, Raichur; patients attending Otorhinolaryngology outpatient department and diagnosed to have rhinosinusitis were selected. Nasal swabs were collected from the middle meatus by diagnostic nasal endoscopy and were sent for culture and sensitivity. Statistical tests were applied for results(Size = 100). Results Out of 100 patients, 52 were males, 48 were females; 88 were adults & 12 were paediatric patients. 59 patients had acute, 32 chronic and 9 had recurrent rhinosinusitis. Most common organisms isolated in acute rhinosinusitis was Klebsiella 28%, Staphylococcus aureus 56% & 66% in chronic & recurrent rhinosinusitis respectively. Klebsiella was sensitive to beta lactams & quinolones, while Staphylococcus aureus was sensitive to beta lactams & cephalosporins. Conclusion Increase in antibiotic use has led to antibiotic resistance. Hence judicious, sensitivity directed antibiotic usage reduces the risk of antibiotic resistance and unnecessary use of antibiotics.
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Affiliation(s)
- Prerana P.
- Department of ENT, Mahadevappa Rampure Medical College, Kalaburgi, Karnataka India
| | - Arvind Sangavi
- Department of ENT, Raichur Institute of Medical Sciences, Raichur, Karnataka India
| | - Venkatesh U
- Department of ENT, Raichur Institute of Medical Sciences, Raichur, Karnataka India
| | | | - Bhushan Chickle
- Department of Orthopaedics, Mahadevappa Rampure Medical College, Kalaburgi, Karnataka India
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3
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Fong P, Lim K, Gnanam A, Charn T. Role of probiotics in chronic rhinosinusitis: a systematic review of randomised, controlled trials. J Laryngol Otol 2023; 137:1300-1311. [PMID: 36999550 DOI: 10.1017/s0022215123000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE This review evaluated the safety profile and efficacy of probiotics in chronic rhinosinusitis and was registered with Prospero (Centre for Reviews and Dissemination number: 42020193529). METHOD Literature databases were searched through inception to August 2022. Randomised, controlled trials exploring adjunctive probiotics in adult chronic rhinosinusitis patients were included. From 948 records screened, 4 randomised, controlled trials were included. RESULTS Probiotics-associated adverse effects comprised epistaxis and abdominal pain. No reduction in Sino-Nasal Outcome Test values before 4 weeks (p = 0.58) or beyond 8 weeks (p = 0.08) of treatment or reduction of severe symptom frequency (p = 0.75) was observed. Symptom relapse in probiotic-treated patients was significantly lower across all timepoints (p = 0.045). Lower sinusitis relapse risks during treatment (risk ratio = 0.49; p = 0.019) and 8 months post-treatment (risk ratio = 0.56, p = 0.013) were observed. Probiotics demonstrated potential in improving Sino-Nasal Outcome Test symptom subscales, including sleep, psychological and rhinology subscales. CONCLUSION The optimal mode of probiotic administration, treatment duration and target patient subgroups requires further study to evaluate the utility of probiotics.
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Affiliation(s)
- P Fong
- Department of Otorhinolaryngology - Head and Neck Surgery, Sengkang General Hospital, SingHealth, Singapore, Singapore
| | - K Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - A Gnanam
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - T Charn
- Department of Otorhinolaryngology - Head and Neck Surgery, Sengkang General Hospital, SingHealth, Singapore, Singapore
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Loperfido A, Cavaliere C, Begvarfaj E, Ciofalo A, D’Erme G, De Vincentiis M, Greco A, Millarelli S, Bellocchi G, Masieri S. The Impact of Antibiotics and Steroids on the Nasal Microbiome in Patients with Chronic Rhinosinusitis: A Systematic Review According to PICO Criteria. J Pers Med 2023; 13:1583. [PMID: 38003898 PMCID: PMC10671981 DOI: 10.3390/jpm13111583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The nasal microbiome represents the main environmental factor of the inflammatory process in chronic rhinosinusitis (CRS). Antibiotics and steroids constitute the mainstay of CRS therapies. However, their impact on microbial communities needs to be better understood. This systematic review summarizes the evidence about antibiotics' and steroids' impact on the nasal microbiota in patients with CRS. METHODS The search strategy was conducted in accordance with the PRISMA guidelines for systematic reviews. The authors searched all papers in the three major medical databases (PubMed, Scopus, and Cochrane Library) using the PICO tool (population, intervention, comparison, and outcomes). The search was carried out using a combination of the key terms "Microbiota" or "Microbiome" and "Chronic Rhinosinusitis". RESULTS Overall, 402 papers were identified, and after duplicate removal (127 papers), excluding papers off-topic (154) and for other structural reasons (110), papers were assessed for eligibility; finally, only 11 papers were included and summarized in the present systematic review. Some authors used only steroids, other researchers used only antibiotics, and others used both antibiotics and steroids. With regard to the use of steroids as exclusive medical treatment, topical mometasone and budesonide were investigated. With regard to the use of antibiotics as exclusive medical treatments, clarithromycin, doxycycline, roxithromycin, and amoxicillin clavulanate were investigated. Regarding the use of both antibiotics and steroids, two associations were investigated: systemic prednisone combined with amoxicillin clavulanate and topical budesonide combined with azithromycin. CONCLUSIONS The impact that therapies can have on the nasal microbiome of CRS patients is very varied. Further studies are needed to understand the role of the nasal microbiome, prevent CRS, and improve therapeutic tools for personalized medicine tailored to the individual patient.
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Affiliation(s)
| | - Carlo Cavaliere
- Department of Sense Organs, Sapienza University, 00185 Rome, Italy
| | - Elona Begvarfaj
- Department of Sense Organs, Sapienza University, 00185 Rome, Italy
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University, 00185 Rome, Italy
| | - Giovanni D’Erme
- UOC Otorinolaringoiatria, Policlinico Umberto I, 00161 Rome, Italy
| | | | - Antonio Greco
- Department of Sense Organs, Sapienza University, 00185 Rome, Italy
| | | | | | - Simonetta Masieri
- Department of Oral and Maxillofacial Sciences, Sapienza University, 00185 Rome, Italy
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Huang J, Xu Y. Autoimmunity: A New Focus on Nasal Polyps. Int J Mol Sci 2023; 24:ijms24098444. [PMID: 37176151 PMCID: PMC10179643 DOI: 10.3390/ijms24098444] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) has long been considered a benign, chronic inflammatory, and hyperplastic disease. Recent studies have shown that autoimmune-related mechanisms are involved in the pathology of nasal polyps. Activated plasma cells, eosinophils, basophils, innate type 2 lymphocytes, mast cells, and proinflammatory cytokine in polyp tissue indicate the mobilization of innate and adaptive immune pathways during polyp formation. The discovery of a series of autoantibodies further supports the autoimmune nature of nasal polyps. Local homeostasis dysregulation, infection, and chronic inflammation may trigger autoimmunity through several mechanisms, including autoantigens overproduction, microbial translocation, molecular mimicry, superantigens, activation or inhibition of receptors, bystander activation, dysregulation of Toll-Like Receptors (TLRs), epitope spreading, autoantigens complementarity. In this paper, we elaborated on the microbiome-mediated mechanism, abnormal host immunity, and genetic changes to update the role of autoimmunity in the pathogenesis of chronic rhinosinusitis with nasal polyps.
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Affiliation(s)
- Jingyu Huang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
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Kotas ME, Patel NN, Cope EK, Gurrola JG, Goldberg AN, Pletcher SD, Seibold MA, Moore CM, Gordon ED. IL-13-associated epithelial remodeling correlates with clinical severity in nasal polyposis. J Allergy Clin Immunol 2023; 151:1277-1285. [PMID: 36736797 PMCID: PMC10243183 DOI: 10.1016/j.jaci.2022.12.826] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Epithelial remodeling is a histopathologic feature of chronic inflammatory airway diseases including chronic rhinosinusitis (CRS). Cell-type shifts and their relationship to CRS endotypes and severity are incompletely described. OBJECTIVE We sought to understand the relationship of epithelial cell remodeling to inflammatory endotypes and disease outcomes in CRS. METHODS Using cell-type transcriptional signatures derived from epithelial single-cell sequencing, we analyzed bulk RNA-sequencing data from sinus epithelial brushings obtained from patients with CRS with and without nasal polyps in comparison to healthy controls. RESULTS The airway epithelium in nasal polyposis displayed increased tuft cell transcripts and decreased ciliated cell transcripts along with an IL-13 activation signature. In contrast, CRS without polyps showed an IL-17 activation signature. IL-13 activation scores were associated with increased tuft cell, goblet cell, and mast cell scores and decreased ciliated cell scores. Furthermore, the IL-13 score was strongly associated with a previously reported activated ("polyp") tuft cell score and a prostaglandin E2 activation signature. The Lund-Mackay score, a computed tomographic metric of sinus opacification, correlated positively with activated tuft cell, mast cell, prostaglandin E2, and IL-13 signatures and negatively with ciliated cell transcriptional signatures. CONCLUSIONS These results demonstrate that cell-type alterations and prostaglandin E2 stimulation are key components of IL-13-induced epithelial remodeling in nasal polyposis, whereas IL-17 signaling is more prominent in CRS without polyps, and that clinical severity correlates with the degree of IL-13-driven epithelial remodeling.
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Affiliation(s)
- Maya E Kotas
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, Calif
| | - Neil N Patel
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, Calif
| | - Emily K Cope
- Center for Applied Microbiome Sciences, the Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Ariz
| | - Jose G Gurrola
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, Calif
| | - Andrew N Goldberg
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, Calif
| | - Steven D Pletcher
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, Calif; Surgical Service, ENT Section, San Francisco VA Medical Center, San Francisco, Calif
| | - Max A Seibold
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colo; Department of Pediatrics, National Jewish Health, Denver, Colo; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado, Aurora, Colo
| | - Camille M Moore
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colo; Department of Biostatistics and Informatics, University of Colorado, Aurora, Colo.
| | - Erin D Gordon
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, Calif.
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7
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Sarkar S, Routhray S, Ramadass B, Parida PK. A Review on the Nasal Microbiome and Various Disease Conditions for Newer Approaches to Treatments. Indian J Otolaryngol Head Neck Surg 2023; 75:755-763. [PMID: 37206729 PMCID: PMC10188862 DOI: 10.1007/s12070-022-03205-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/23/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction: Commensal bacteria have always played a significant role in the maintenance of health and disease but are being unravelled only recently. Studies suggest that the nasal microbiome has a significant role in the development of various disease conditions. Search engines were used for searching articles having a nasal microbiome and disease correlation. In olfactory dysfunction, dysbiosis of the microbiome may have a significant role to play in the pathogenesis. The nasal microbiome influences the phenotype of CRS and is also capable of modulating the immune response and plays a role in polyp formation. Microbiome dysbiosis has a pivotal role in the development of Allergic Rhinitis; but, yet known how is this role played. The nasal microbiome has a close association with the severity and phenotype of asthma. They contribute significantly to the onset, severity, and development of asthma. The nasal microbiome has a significant impact on the immunity and protection of its host. The nasal microbiome has been a stimulus in the development of Otitis Media and its manifestations. Studies suggest that the resident nasal microbiome is responsible for the initiation of neurodegenerative diseases like Parkinson's Disease.Materials and Methods: Literature search from PubMed, Medline, and Google with the Mesh terms: nasal microbiome AND diseases. Conclusion: With increasing evidence on the role of the nasal microbiome on various diseases, it would be interesting to see how this microbiome can be modulated by pro/pre/post biotics to prevent a disease or the severity of illness.
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Affiliation(s)
- Saurav Sarkar
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Samapika Routhray
- Department of Dentistry, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Balamurugan Ramadass
- Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Pradipta Kumar Parida
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, India
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Vediappan RS, Bennett C, Cooksley C, Bassiouni A, Scott JR, Al Suliman YA, Lumyongsatien J, Moratti S, Psaltis AJ, Vreugde S, Wormald PJ. Wound healing in endoscopic sinus surgery: Phase 1 clinical trial evaluating the role of Chitogel with adjuvants. Clin Otolaryngol 2023; 48:158-166. [PMID: 36317791 DOI: 10.1111/coa.13996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/07/2022] [Accepted: 10/16/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This study aimed to determine the safety and efficacy of Chitogel, with and without Deferiprone (Def) and Gallium Protoporphyrin (GaPP), as a promoter of wound healing to improve surgical outcomes after endoscopic sinus susgery. DESIGN A double-blinded, randomised control human clinical trial was conducted in patients undergoing ESS as a treatment for chronic rhinosinusitis. Participants underwent functional ESS or FESS with drill out as required and were randomised to receive test product Chitogel, Chitogel in combination with Def or Def-GaPP versus no packing (control). SETTING Ostial stenosis and persistent inflammation are the main reasons for revision endoscopic sinus surgery (ESS). Post-operative (PO) dressings can improve PO wound healing and patient outcomes after ESS. PARTICIPANTS Eighty two patients were included in this study with 79 patients completing the study with 40 undergoing full house FESS and 39 FESS plus frontal drillout. MAIN OUTCOME MEASURES Patients were followed up at 2, 6 and 12 weeks PO, and outcome scores such as SNOT-22, VAS and LKS, pre and post-surgery (12 weeks) were compared. RESULTS Seventy nine patients completed the study, there was a significant reduction in SNOT-22 score and improvement of VAS at 12 weeks in patients treated with Chitogel compared to control (p < .05). In those patients, the mean ostium area for the Chitogel and the Chitogel + Def + GaPP groups was higher across all three sinuses compared to the no-treatment control group, without statistical significance. Sphenoid sinus ostium was significantly more patent in patients treated with Chitogel compared to the control at the 12-week time point (p < .05). CONCLUSION Chitogel as a PO dressing after ESS results in the best patient-reported symptom scores and objective measurements. The combination of Def and GaPP to Chitogel though proving safe, had no effect on the ostium patency or mucosal healing.
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Affiliation(s)
- Rajan Sundaresan Vediappan
- Department of Surgery - Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, South Australia, Australia.,Department of ENT, Unit-1, Head & Neck, Skull Base Surgery, Christian Medical College, Vellore, India
| | - Catherine Bennett
- Department of Surgery - Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, South Australia, Australia
| | - Clare Cooksley
- Department of Surgery - Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ahmed Bassiouni
- Department of Surgery - Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, South Australia, Australia
| | - John R Scott
- Department of Otolaryngology-Head & Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yazeed A Al Suliman
- Department of Otolaryngology, Head and Neck Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Jate Lumyongsatien
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Stephen Moratti
- Department of Chemistry, Otago University, Dunedin, New Zealand
| | - Alkis J Psaltis
- Department of Surgery - Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Otolaryngology Head and Neck Surgery, Central Adelaide Health Network, Adelaide, Australia
| | - Sarah Vreugde
- Department of Surgery - Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Otolaryngology Head and Neck Surgery, Central Adelaide Health Network, Adelaide, Australia
| | - Peter-John Wormald
- Department of Surgery - Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Otolaryngology Head and Neck Surgery, Central Adelaide Health Network, Adelaide, Australia
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9
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Huang S, Hon K, Bennett C, Hu H, Menberu M, Wormald PJ, Zhao Y, Vreugde S, Liu S. Corynebacterium accolens inhibits Staphylococcus aureus induced mucosal barrier disruption. Front Microbiol 2022; 13:984741. [PMID: 36187946 PMCID: PMC9515799 DOI: 10.3389/fmicb.2022.984741] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background Corynebacterium accolens (C. accolens) is a common nasal colonizer, whereas Staphylococcus aureus (S. aureus) is typically regarded a pathogenic organism in patients with chronic rhinosinusitis (CRS). This study aims to evaluate the interaction of the two bacteria in vitro. Methods Clinical isolates of C. accolens and S. aureus from sinonasal swabs, as well as primary human nasal epithelial cells (HNECs) cultured from cellular brushings of both healthy and CRS patients were used for this study. The cell-free culture supernatants of all isolates grown alone and in co-cultures were tested for their effects on transepithelial electrical resistance (TER), FITC-Dextran permeability, lactate dehydrogenase (LDH), and IL-6 and IL-8 secretion of HNECs. Confocal scanning laser microscopy and immunofluorescence were also used to visualize the apical junctional complexes. C. accolens cell-free culture supernatants were also tested for antimicrobial activity and growth on planktonic and biofilm S. aureus growth. Results The cell-free culture supernatants of 3\C. accolens strains (at 60% for S. aureus reference strain and 30% concentration for S. aureus clinical strains) inhibited the growth of both the planktonic S. aureus reference and clinical strains significantly. The C. accolens cell-free culture supernatants caused no change in the TER or FITC-Dextran permeability of the HNEC-ALI cultures, while the cell-free culture supernatants of S. aureus strains had a detrimental effect. Cell-free culture supernatants of C. accolens co-cultured with both the clinical and reference strains of S. aureus delayed the S. aureus-dependent mucosal barrier damage in a dose-dependent manner. Conclusion Corynebacterium accolens cell-free culture supernatants appear to inhibit the growth of the S. aureus planktonic bacteria, and may reduce the mucosal barrier damage caused by S. aureus.
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Affiliation(s)
- Shuman Huang
- Department of Surgery-Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Karen Hon
- Department of Surgery-Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Catherine Bennett
- Department of Surgery-Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Hua Hu
- Department of Surgery-Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Department of Otolaryngology, Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Martha Menberu
- Department of Surgery-Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Peter-John Wormald
- Department of Surgery-Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Yulin Zhao
- Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Sarah Vreugde
- Department of Surgery-Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Sha Liu
- Department of Surgery-Otolaryngology Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
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Abstract
Chronic low-level inflammation is a causative factor in many of our common diseases. Switching to an anti-inflammatory diet is an important step that patients can take in for rectifying this risk factor. In this review, the author discusses the essential components of an anti-inflammatory diet and its contribution not only to the overall well-being but also to the body's defense against disease. The human microbiome is reviewed in detail and dietary connections and recommendations are explained for several otolaryngologic conditions.
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Affiliation(s)
- Agnes Czibulka
- Yale University, Quinnipiac University, 6 Burgis Lane, Guilford 06437, USA.
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11
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Menberu MA, Cooksley C, Ramezanpour M, Bouras G, Wormald PJ, Psaltis AJ, Vreugde S. In vitro and in vivo evaluation of probiotic properties of Corynebacterium accolens isolated from the human nasal cavity. Microbiol Res 2021; 255:126927. [PMID: 34875424 DOI: 10.1016/j.micres.2021.126927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/26/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022]
Abstract
Corynebacterium accolens strains are increasingly recognized as beneficial bacteria that can confer a health benefit on the host. In the current study, the probiotic potential of three C. accolens strains, C779, C781 and C787 derived from a healthy human nasal cavity were investigated. These strains were examined for their adhesion to HNECs, competition with Staphylococcus aureus for adhesion, toxicity, induction of IL-6, antibiotic susceptibility and the presence of antibiotic resistance and virulence genes. Furthermore, the safety and efficacy of strains were evaluated in vivo using Caenorhabditis elegans. The adhesion capacity of C. accolens to HNECs was strain-dependent. Highest adhesion was observed for strain C781. None of the C. accolens strains tested caused cell lysis. All strains were able to outcompete S. aureus for cell adhesion and caused a significant decrease of IL-6 production by HNECs co-exposed to S. aureus when compared to the control groups. All strains were sensitive or showed intermediate sensitivity to 10 different antibiotics. Whole Genome Sequence analysis showed C. accolens C781 and C787 did not possess antibiotic resistance genes whereas strain C779 harboured 5 genes associated with resistance to Aminoglycoside, Chloramphenicol and Erythromycin. In addition, no virulence genes were detected in any of the 3 strains. Moreover, the tested strains had no detrimental effect on worm survival and induced protection from S. aureus-mediated infection. Taken all together, C. accolens strains, C781 and C787 displayed probiotic potential and hold promise for use in clinical applications for combating dysbiosis in chronic rhinosinusitis.
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Affiliation(s)
- Martha Alemayehu Menberu
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville, SA, Australia; Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Clare Cooksley
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville, SA, Australia
| | - Mahnaz Ramezanpour
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville, SA, Australia
| | - George Bouras
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville, SA, Australia
| | - Peter-John Wormald
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville, SA, Australia
| | - Alkis James Psaltis
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville, SA, Australia
| | - Sarah Vreugde
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville, SA, Australia.
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Elgamal Z, Singh P, Geraghty P. The Upper Airway Microbiota, Environmental Exposures, Inflammation, and Disease. ACTA ACUST UNITED AC 2021; 57:medicina57080823. [PMID: 34441029 PMCID: PMC8402057 DOI: 10.3390/medicina57080823] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023]
Abstract
Along with playing vital roles in pathogen exclusion and immune system priming, the upper airways (UAs) and their microbiota are essential for myriad physiological functions such as conditioning and transferring inhaled air. Dysbiosis, a microbial imbalance, is linked with various diseases and significantly impedes the quality of one’s life. Daily inhaled exposures and/or underlying conditions contribute to adverse changes to the UA microbiota. Such variations in the microbial community exacerbate UA and pulmonary disorders via modulating inflammatory and immune pathways. Hence, exploring the UA microbiota’s role in maintaining homeostasis is imperative. The microbial composition and subsequent relationship with airborne exposures, inflammation, and disease are crucial for strategizing innovating UA diagnostics and therapeutics. The development of a healthy UA microbiota early in life contributes to normal respiratory development and function in the succeeding years. Although different UA cavities present a unique microbial profile, geriatrics have similar microbes across their UAs. This lost community segregation may contribute to inflammation and disease, as it stimulates disadvantageous microbial–microbial and microbial–host interactions. Varying inflammatory profiles are associated with specific microbial compositions, while the same is true for many disease conditions and environmental exposures. A shift in the microbial composition is also detected upon the administration of numerous therapeutics, highlighting other beneficial and adverse side effects. This review examines the role of the UA microbiota in achieving homeostasis, and the impact on the UAs of environmental airborne pollutants, inflammation, and disease.
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Affiliation(s)
- Ziyad Elgamal
- Department of Biomedical Science, University of Guelph, Guelph, ON N1G 2W1, Canada;
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, State University of New York Downstate Medical Centre, Brooklyn, NY 11203, USA
| | - Pratyush Singh
- Department of Biology, University of Western Ontario, London, ON N6A 5B7, Canada;
| | - Patrick Geraghty
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, State University of New York Downstate Medical Centre, Brooklyn, NY 11203, USA
- Correspondence: ; Tel.: +1-718-270-3141
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Padayachee Y, Flicker S, Linton S, Cafferkey J, Kon OM, Johnston SL, Ellis AK, Desrosiers M, Turner P, Valenta R, Scadding GK. Review: The Nose as a Route for Therapy. Part 2 Immunotherapy. FRONTIERS IN ALLERGY 2021; 2:668781. [PMID: 35387044 PMCID: PMC8974912 DOI: 10.3389/falgy.2021.668781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022] Open
Abstract
The nose provides a route of access to the body for inhalants and fluids. Unsurprisingly it has a strong immune defense system, with involvement of innate (e.g., epithelial barrier, muco- ciliary clearance, nasal secretions with interferons, lysozyme, nitric oxide) and acquired (e.g., secreted immunoglobulins, lymphocytes) arms. The lattice network of dendritic cells surrounding the nostrils allows rapid uptake and sampling of molecules able to negotiate the epithelial barrier. Despite this many respiratory infections, including SARS-CoV2, are initiated through nasal mucosal contact, and the nasal mucosa is a significant "reservoir" for microbes including Streptococcus pneumoniae, Neisseria meningitidis and SARS -CoV-2. This review includes consideration of the augmentation of immune defense by the nasal application of interferons, then the reduction of unnecessary inflammation and infection by alteration of the nasal microbiome. The nasal mucosa and associated lymphoid tissue (nasopharynx-associated lymphoid tissue, NALT) provides an important site for vaccine delivery, with cold-adapted live influenza strains (LAIV), which replicate intranasally, resulting in an immune response without significant clinical symptoms, being the most successful thus far. Finally, the clever intranasal application of antibodies bispecific for allergens and Intercellular Adhesion Molecule 1 (ICAM-1) as a topical treatment for allergic and RV-induced rhinitis is explained.
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Affiliation(s)
- Yorissa Padayachee
- Department of Respiratory Medicine, Faculty of Medicine, Imperial College Healthcare NHS Trust, Imperial College London, London, United Kingdom
| | - Sabine Flicker
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Sophia Linton
- Division of Allergy and Immunology, Department of Medicine, Queen's University, Kingston, ON, Canada
- Allergy Research Unit, Kingston Health Sciences Centre (KHSC), Kingston, ON, Canada
| | - John Cafferkey
- Department of Respiratory Medicine, Faculty of Medicine, Imperial College Healthcare NHS Trust, Imperial College London, London, United Kingdom
| | - Onn Min Kon
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Sebastian L. Johnston
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Anne K. Ellis
- Division of Allergy and Immunology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Martin Desrosiers
- Department of Otorhinolaryngologie, The University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Paul Turner
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Rudolf Valenta
- Division of Immunopathology, Medical University of Vienna, Vienna, Austria
| | - Glenis Kathleen Scadding
- Royal National Ear Nose and Throat Hospital, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Division of Infection and Immunity, Faculty of Medical Sciences, University College London, London, United Kingdom
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14
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Bourdillon AT, Edwards HA. Review of probiotic use in otolaryngology. Am J Otolaryngol 2021; 42:102883. [PMID: 33453564 DOI: 10.1016/j.amjoto.2020.102883] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/25/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Probiotics have garnered considerable attention as an intervention for various conditions common to otolaryngology. The purpose of this review is to evaluate the current literature to offer recommendations about the safety and efficacy of probiotic management in otolaryngologic conditions. STUDY DESIGN Narrative review. METHODS PubMed and Google Scholar were queried using pertinent keywords to retrieve relevant studies with particular focus in the recent 5 years. All abstracts were assessed and studies, reviews and meta-analyses achieving evaluation of probiotic therapies or characterization of microbiome changes were included for further review. Studies were categorized by condition or anatomic region across various subspecialties. Key data parameters were extracted and evaluated across studies and treatment types. RESULTS Strong evidence exists for the use probiotic agents to improve symptoms for allergic rhinitis, chronic rhinosinusitis and certain dental conditions. Despite promising results, further investigation is needed to evaluate and optimize probiotic delivery for mitigating otitis media, oropharyngeal inflammation and upper respiratory tract infections. Preclinical studies suggest that probiotics may potentially offer benefit for voice prosthesis maintenance, wound healing and mitigation of oral dysplasia. CONCLUSION Probiotic therapies may offer clinical benefit in a variety of contexts within the field of otolaryngology, especially for short-term relief of certain inflammatory conditions of the oral cavity, auditory and nasal cavities. Further investigation is warranted for evaluation of long-term outcomes and pathogenic deterrence.
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Affiliation(s)
- Alexandra T Bourdillon
- Division of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States of America.
| | - Heather A Edwards
- Department of Otolaryngology, Boston University School of Medicine, Boston, MA, United States of America.
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Gan W, Yang F, Meng J, Liu F, Liu S, Xian J. Comparing the nasal bacterial microbiome diversity of allergic rhinitis, chronic rhinosinusitis and control subjects. Eur Arch Otorhinolaryngol 2021; 278:711-718. [PMID: 32860131 DOI: 10.1007/s00405-020-06311-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Until now, the microbiome of the nasal cavity and its contribution to nasal mucosal disease has remained poorly understood. The advent of cultivation-free molecular methods makes it possible to characterize the total microbiome of the nasal cavity. We sought to assess the microbial diversity and composition of the middle meatus in allergic rhinitis (AR) patients, chronic rhinosinusitis patients without polyps (CRSsNP) and a control population to determine the microbiota associated with the pathogenesis of AR and CRSsNP. METHODS Microbial characterization was determined using 16S rRNA gene sequencing of 122 nasal swabs collected from patients with AR (n = 52) and CRSsNP (n = 37), and from healthy controls (n = 33). RESULTS There was no difference in nasal microbiome richness and diversity among the three groups, and the dominant phyla were similar among three groups including Firmicutes, Proteobacteria, Actinobacteria and Bacteroidetes. However, Spirochaetae abundance was significantly higher in AR than in the control group after FDR correction (FDR p = 0.021). At the genus level, although there was no statistical significance after FDR correction, there was a trend that Pseudomonas and Peptostreptococcaceae abundance were higher in AR than in controls (p = 0.005, p = 0.005) and CRSsNP (p = 0.023, p = 0.034); Lactobacillus abundance was lower in AR than in controls (p = 0.021); Moraxella abundance was lower in CRSsNP than in controls (p = 0.006); Haemophilus abundance was higher in CRSsNP than in AR (p = 0.003) but lower in AR than in controls (p = 0.018). CONCLUSION These results suggested that microbial dysbiosis may play a role in the pathogenesis of heterogeneous nasal mucosal inflammation.
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Affiliation(s)
- Weigang Gan
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Fengjuan Yang
- Department of Otorhinolaryngology, Nanchong Fifth People's Hospital, Nanchong, Sichuan, People's Republic of China
| | - Juan Meng
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China.
| | - Feng Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Shixi Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Junming Xian
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Menberu MA, Liu S, Cooksley C, Hayes AJ, Psaltis AJ, Wormald PJ, Vreugde S. Corynebacterium accolens Has Antimicrobial Activity against Staphylococcus aureus and Methicillin-Resistant S. aureus Pathogens Isolated from the Sinonasal Niche of Chronic Rhinosinusitis Patients. Pathogens 2021; 10:pathogens10020207. [PMID: 33672855 PMCID: PMC7918835 DOI: 10.3390/pathogens10020207] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/12/2022] Open
Abstract
Corynebacterium accolens is the predominant species of the healthy human nasal microbiota, and its relative abundance is decreased in the context of chronic rhinosinusitis (CRS). This study aimed to evaluate the antimicrobial potential of C. accolens isolated from a healthy human nasal cavity against planktonic and biofilm growth of Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) clinical isolates (CIs) from CRS patients. Nasal swabs from twenty non-CRS control subjects were screened for the presence of C. accolens using microbiological and molecular techniques. C. accolens CIs and their culture supernatants were tested for their antimicrobial activity against eight S. aureus and eight MRSA 4CIs and S. aureus ATCC25923. The anti-biofilm potential of C. accolens cell-free culture supernatants (CFCSs) on S. aureus biofilms was also assessed. Of the 20 nasal swabs, 10 C. accolens CIs were identified and confirmed with rpoB gene sequencing. All isolates showed variable antimicrobial activity against eight out of 8 S. aureus and seven out of eight MRSA CIs. Culture supernatants from all C. accolens CIs exhibited a significant dose-dependent antibacterial activity (p < 0.05) against five out of five representative S. aureus and MRSA CIs. This inhibition was abolished after proteinase K treatment. C. accolens supernatants induced a significant reduction in metabolic activity and biofilm biomass of S. aureus and MRSA CIs compared to untreated growth control (p < 0.05). C. accolens exhibited antimicrobial activity against S. aureus and MRSA CIs in both planktonic and biofilm forms and holds promise for the development of innovative probiotic therapies to promote sinus health.
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Affiliation(s)
- Martha Alemayehu Menberu
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville 5011, Australia; (M.A.M.); (S.L.); (C.C.); (A.J.P.); (P.-J.W.)
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar 196, Ethiopia
| | - Sha Liu
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville 5011, Australia; (M.A.M.); (S.L.); (C.C.); (A.J.P.); (P.-J.W.)
| | - Clare Cooksley
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville 5011, Australia; (M.A.M.); (S.L.); (C.C.); (A.J.P.); (P.-J.W.)
| | - Andrew James Hayes
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne and The Royal Melbourne Hospital, Melbourne 3000, Australia;
| | - Alkis James Psaltis
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville 5011, Australia; (M.A.M.); (S.L.); (C.C.); (A.J.P.); (P.-J.W.)
| | - Peter-John Wormald
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville 5011, Australia; (M.A.M.); (S.L.); (C.C.); (A.J.P.); (P.-J.W.)
| | - Sarah Vreugde
- Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville 5011, Australia; (M.A.M.); (S.L.); (C.C.); (A.J.P.); (P.-J.W.)
- Correspondence: ; Tel.: +61-(0)8-8222-6928
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17
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Lambert PA, Gill AL, Gill SR, Allen PD, Man L. Microbiomics of irrigation with xylitol or Lactococcus lactis in chronic rhinosinusitis. Laryngoscope Investig Otolaryngol 2021; 6:64-70. [PMID: 33614931 PMCID: PMC7883620 DOI: 10.1002/lio2.524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/11/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Topical sinonasal rinse therapies may alter the local microbiome and improve disease control in chronic rhinosinusitis (CRS). The objective of this study was to examine microbiome changes in post-surgical CRS patients when rinsing with commercially available products containing xylitol or Lactococcus lactis. METHODS A crossover-type protocol with a washout period was designed. Swab samples from anterior ethmoid cavities of CRS patients were collected prospectively at baseline. Subjects were provided packets containing either L. lactis W136 or xylitol in non-blinded fashion and instructed to add it to their rinse bottles daily for 28 days, after which another swab was taken. A saline wash-out period was completed and a third swab taken. A final 28-day regimen of the opposite product was followed by a final swab. DNA extraction and sequencing of the 16S rRNA gene allowed for global microbiome analysis. RESULTS We enrolled 25 subjects with CRS and 10 controls resulting in 70 adequate samples. Increased detection of Lactococcus was observed after use of L. lactis. No significant trends in alpha or beta diversity as a result of treatment were observed. SNOT-22 score did not change significantly following treatment with xylitol, L. lactis, or saline. CONCLUSION We did not detect any major clinical or microbiome-level effect due to treatment with two topical rinse products. Further research is needed to elucidate their clinical utility and possible probiotic effect. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Paul A. Lambert
- Department of Otolaryngology Head and Neck SurgeryUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Ann L. Gill
- Department of Microbiology and ImmunologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Steven R. Gill
- Department of Microbiology and ImmunologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Paul D. Allen
- Department of Otolaryngology Head and Neck SurgeryUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Li‐Xing Man
- Department of Otolaryngology Head and Neck SurgeryUniversity of Rochester Medical CenterRochesterNew YorkUSA
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18
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Svistushkin VM, Nikiforova GN, Vorobjeva NV, Dekhanov AS, Dagil YA, Bredova OY, Eremeeva KV. [Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis]. Vestn Otorinolaringol 2021; 86:105-112. [PMID: 34964339 DOI: 10.17116/otorino202186061105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The review presents the current understanding of the pathogenesis of chronic rhinosinusitis. The causes of damage to the mucous membrane of the paranasal sinuses are most often the result of a combination of immunological, infectious and anatomical factors. This indicates the need for a multidisciplinary approach to the study of the pathogenesis of this pathology. There is no single universally recognized classification of chronic rhinosinusitis, which takes into account histological and immunological changes in the mucous membrane of the paranasal sinuses. The discovery of the mechanism of completion of the life cycle of neutrophils - the formation of a neutrophil extracellular trap or NETosis, different from necrosis and apoptosis, opened up new prospects in the study of the pathogenesis of inflammatory processes, including rhinosinusitis. Neutrophil extracellular traps reduce the permeability of the epithelial barrier in the mucous membrane of the paranasal sinuses. This determines their possible role in the etiopathogenesis of rhinosinusitis. In recent years, more and more attention has been paid to the feasibility, effectiveness and safety of therapy that affects the immune component of the inflammatory process, including NETosis. The data obtained in the study of extracellular traps can be used in clinical practice. It is neutrophil extracellular traps that can become a potential target in the treatment of patients with chronic rhinosinusitis.
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Affiliation(s)
- V M Svistushkin
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - G N Nikiforova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - A S Dekhanov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | | | | | - K V Eremeeva
- Sechenov First Moscow State Medical University, Moscow, Russia
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19
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Menberu MA, Hayes AJ, Liu S, Psaltis AJ, Wormald PJ, Vreugde S. Tween 80 and its derivative oleic acid promote the growth of Corynebacterium accolens and inhibit Staphylococcus aureus clinical isolates. Int Forum Allergy Rhinol 2020; 11:810-813. [PMID: 33156566 DOI: 10.1002/alr.22730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Martha Alemayehu Menberu
- Department of Otolaryngology-Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, University of Adelaide, Woodville, SA, Australia.,Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Andrew James Hayes
- Department of Otolaryngology-Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, University of Adelaide, Woodville, SA, Australia.,Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne and The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Sha Liu
- Department of Otolaryngology-Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, University of Adelaide, Woodville, SA, Australia
| | - Alkis James Psaltis
- Department of Otolaryngology-Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, University of Adelaide, Woodville, SA, Australia
| | - Peter-John Wormald
- Department of Otolaryngology-Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, University of Adelaide, Woodville, SA, Australia
| | - Sarah Vreugde
- Department of Otolaryngology-Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, University of Adelaide, Woodville, SA, Australia
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20
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Paramasivan S, Bassiouni A, Shiffer A, Dillon MR, Cope EK, Cooksley C, Ramezanpour M, Moraitis S, Ali MJ, Bleier B, Callejas C, Cornet ME, Douglas RG, Dutra D, Georgalas C, Harvey RJ, Hwang PH, Luong AU, Schlosser RJ, Tantilipikorn P, Tewfik MA, Vreugde S, Wormald P, Caporaso JG, Psaltis AJ. The international sinonasal microbiome study: A multicentre, multinational characterization of sinonasal bacterial ecology. Allergy 2020; 75:2037-2049. [PMID: 32167574 DOI: 10.1111/all.14276] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/20/2019] [Accepted: 12/18/2019] [Indexed: 02/06/2023]
Abstract
The sinonasal microbiome remains poorly defined, with our current knowledge based on a few cohort studies whose findings are inconsistent. Furthermore, the variability of the sinus microbiome across geographical divides remains unexplored. We characterize the sinonasal microbiome and its geographical variations in both health and disease using 16S rRNA gene sequencing of 410 individuals from across the world. Although the sinus microbial ecology is highly variable between individuals, we identify a core microbiome comprised of Corynebacterium, Staphylococcus, Streptococcus, Haemophilus and Moraxella species in both healthy and chronic rhinosinusitis (CRS) cohorts. Corynebacterium (mean relative abundance = 44.02%) and Staphylococcus (mean relative abundance = 27.34%) appear particularly dominant in the majority of patients sampled. Amongst patients suffering from CRS with nasal polyps, a statistically significant reduction in relative abundance of Corynebacterium (40.29% vs 50.43%; P = .02) was identified. Despite some measured differences in microbiome composition and diversity between some of the participating centres in our cohort, these differences would not alter the general pattern of core organisms described. Nevertheless, atypical or unusual organisms reported in short-read amplicon sequencing studies and that are not part of the core microbiome should be interpreted with caution. The delineation of the sinonasal microbiome and standardized methodology described within our study will enable further characterization and translational application of the sinus microbiota.
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Affiliation(s)
- Sathish Paramasivan
- Department of Otolaryngology, Head and Neck Surgery University of Adelaide Adelaide SA Australia
| | - Ahmed Bassiouni
- Department of Otolaryngology, Head and Neck Surgery University of Adelaide Adelaide SA Australia
| | - Arron Shiffer
- Pathogen and Microbiome Institute Northern Arizona University Flagstaff AZ USA
| | - Matthew R. Dillon
- Pathogen and Microbiome Institute Northern Arizona University Flagstaff AZ USA
| | - Emily K. Cope
- Pathogen and Microbiome Institute Northern Arizona University Flagstaff AZ USA
| | - Clare Cooksley
- Department of Otolaryngology, Head and Neck Surgery University of Adelaide Adelaide SA Australia
| | - Mahnaz Ramezanpour
- Department of Otolaryngology, Head and Neck Surgery University of Adelaide Adelaide SA Australia
| | - Sophia Moraitis
- Department of Otolaryngology, Head and Neck Surgery University of Adelaide Adelaide SA Australia
| | | | - Benjamin Bleier
- Department of Otolaryngology Massachusetts Eye and Ear Infirmary Harvard Medical School Boston MA USA
| | - Claudio Callejas
- Department of Otolaryngology Pontificia Universidad Catolica de Chile Santiago Chile
| | | | | | - Daniel Dutra
- Department of Otorhinolaryngology University of Sao Paulo Sao Paulo Brazil
| | - Christos Georgalas
- Department of Otorhinolaryngology Amsterdam UMC Amsterdam The Netherlands
| | - Richard J. Harvey
- Department of Otolaryngology, Rhinology and Skull base University of New South Wales Sydney NSW Australia
- Faculty of Medicine and Health sciences Macquarie University Sydney NSW Australia
| | - Peter H. Hwang
- Department of Otolaryngology ‐Head and Neck Surgery Stanford University Stanford CA USA
| | - Amber U. Luong
- Department of Otolaryngology ‐Head and Neck Surgery University of Texas Austin TX USA
| | - Rodney J. Schlosser
- Department of Otolaryngology Medical University of South Carolina Charleston SC USA
| | - Pongsakorn Tantilipikorn
- Department of Otorhinolaryngology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - Marc A. Tewfik
- Department of Otolaryngology ‐ Head and Neck Surgery McGill University Montreal QC Canada
| | - Sarah Vreugde
- Department of Otolaryngology, Head and Neck Surgery University of Adelaide Adelaide SA Australia
| | - Peter‐John Wormald
- Department of Otolaryngology, Head and Neck Surgery University of Adelaide Adelaide SA Australia
| | - J. Gregory Caporaso
- Pathogen and Microbiome Institute Northern Arizona University Flagstaff AZ USA
| | - Alkis J. Psaltis
- Department of Otolaryngology, Head and Neck Surgery University of Adelaide Adelaide SA Australia
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21
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Renteria AE, Maniakas A, Mfuna LE, Asmar MH, Gonzalez E, Desrosiers M. Low-dose and long-term azithromycin significantly decreases Staphylococcus aureus in the microbiome of refractory CRS patients. Int Forum Allergy Rhinol 2020; 11:93-105. [PMID: 32713109 DOI: 10.1002/alr.22653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 06/01/2020] [Accepted: 06/25/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The sinonasal microbiome is believed to play an important role in the pathophysiology of refractory chronic rhinosinusitis (CRS). We evaluated changes in the microbiome following a 4-month course of low-dose azithromycin. Assessing microbiome alterations following such a treatment may help identify underlying mechanisms of this drug. METHODS A total of 48 adults with refractory CRS were enrolled in a double-blind, randomized, placebo-controlled trial. Patients were randomized to 250 mg of azithromycin or placebo 3 times weekly for 4 months. During this time, daily budesonide saline irrigations were continued. Sinonasal swabs were collected by endoscopically-assisted method prior to treatment initiation and at the end of it, and sent for 16S ribosomal RNA gene sequencing. High-resolution ANCHOR pipeline was used to infer and annotate putative species. The 2 patient groups were compared using DESeq2 differential abundance analysis. RESULTS From initiation to the end of azithromycin treatment, patients showed a significant difference in beta diversity analysis (p = 0.0004) along with a significant decrease in 71 different operational taxonomic units (OTUs) of Staphylococcus aureus (false discovery rate [FDR] < 0.05) obtained from the differential abundance analysis. This was not observed in placebo-treated patients. By the end of treatments, azithromycin-treated patients had a significant decrease in 29 different OTUs of S. aureus (FDR < 0.05) when compared to placebo. CONCLUSION A 4-month course of 250 mg of azithromycin 3 times weekly in patients with refractory CRS significantly decreases S. aureus abundance in the sinonasal microbiome. Considering the pathogenic role of S. aureus in the refractory CRS population, azithromycin may constitute an additional therapeutic option to help control this disease.
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Affiliation(s)
- Axel E Renteria
- Centre de Recherche du Centre Hospitalier, de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.,Département d'oto-rhino-laryngologie et chirurgie cervico-faciale du centre hospitalier, de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Anastasios Maniakas
- Centre de Recherche du Centre Hospitalier, de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.,Département d'oto-rhino-laryngologie et chirurgie cervico-faciale du centre hospitalier, de l'Université de Montréal (CHUM), Montréal, QC, Canada.,Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Leandra Endam Mfuna
- Centre de Recherche du Centre Hospitalier, de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Marc-Henri Asmar
- Centre de Recherche du Centre Hospitalier, de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Emmanuel Gonzalez
- Canadian Centre for Computational Genomics (C3G), Department of Human Genetics, McGill University, Montréal, QC, Canada.,Microbiome Research Platform, McGill Interdisciplinary Initiative in Infection and Immunity (MI4), Genome Centre, McGill University, Montréal, QC, Canada
| | - Martin Desrosiers
- Centre de Recherche du Centre Hospitalier, de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.,Département d'oto-rhino-laryngologie et chirurgie cervico-faciale du centre hospitalier, de l'Université de Montréal (CHUM), Montréal, QC, Canada
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22
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Leszczyńska J, Stryjewska-Makuch G, Ścierski W, Lisowska G. Bacterial Flora of the Nose and Paranasal Sinuses Among Patients Over 65 Years Old with Chronic Rhinosinusitis Who Underwent Endoscopic Sinus Surgery. Clin Interv Aging 2020; 15:207-215. [PMID: 32103923 PMCID: PMC7027888 DOI: 10.2147/cia.s215917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/04/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Chronic rhinosinusitis (CRS) is one of the most common chronic diseases in the geriatric population. However, CRS inflammatory mechanisms in older people have not been thoroughly investigated. Our work aimed to analyze the bacterial flora of the nose and paranasal sinuses in patients with CRS over 65 years of age, including comorbidities, previously performed endoscopic sinus surgery (ESS), presence or absence of polyps and the extent of the inflammatory process. PATIENTS AND METHODS The study involved 529 patients between 18 and 84 years of age with chronic rhinosinusitis who underwent endoscopic sinus surgery. There were 101 patients separated over 65 years of age (M = 52, K = 49, mean age 69 ± 0.7 years). The control group consisted of 168 patients aged 18-40 years with CRS. The bacterial culture of material collected from the patients during ESS was analyzed. RESULTS In the group of patients over 65 years of age, more frequent occurrence of Proteus spp. and Pseudomonas aeruginosa was found in comparison to younger patients. In older patients with bronchial asthma, the occurrence of S. aureus, Escherichia coli, and Citrobacter spp. was more frequent than in control group. Multiple sinus surgical procedures in older patients were associated with the dominance of Staphylococcus aureus and Escherichia coli, which was not demonstrated in the control group. There were no statistically significant differences between the occurrence of bacterial strain and the presence of polyps, both in the group of patients over 65 years of age as well as in the control group. CONCLUSION The bacterial flora of patients with CRS is different in older and younger patients. A different therapeutic approach should be considered in older patients with CRS, but this problem requires further studies.
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Affiliation(s)
- Joanna Leszczyńska
- Department of Laryngology and Laryngological Oncology, Upper Silesian Medical Centre of Silesian Medical University, Katowice, Poland
| | - Grażyna Stryjewska-Makuch
- Department of Laryngology and Laryngological Oncology, Upper Silesian Medical Centre of Silesian Medical University, Katowice, Poland
| | - Wojciech Ścierski
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
| | - Grażyna Lisowska
- Department of Otorhinolaryngology and Laryngological Oncology, Medical University of Silesia, Zabrze, Poland
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23
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Wang JC, Moore CA, Epperson MV, Sedaghat AR. Association of the sinonasal bacterial microbiome with clinical outcomes in chronic rhinosinusitis: a systematic review. Int Forum Allergy Rhinol 2020; 10:433-443. [PMID: 32052920 PMCID: PMC9290466 DOI: 10.1002/alr.22524] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/15/2019] [Accepted: 12/18/2019] [Indexed: 12/16/2022]
Abstract
Background The association between sinonasal microbiome and clinical outcomes of patients with chronic rhinosinusitis (CRS) is unclear. We performed a systematic review of prior studies evaluating the CRS microbiome in relation to clinical outcomes. Methods Computerized searches of PubMed/Medline, Cochrane, and EMBASE were updated through October 2019 revealing a total of 9 studies including 244 CRS patients. A systematic review of the literature was performed, including data extraction focusing on sample region, sequencing platforms, predominant organisms, and outcomes measures. Results Nine criterion‐meeting studies included 244 CRS patients, with varied results. Eight studies used 16s–ribosomal RNA (16s‐rRNA) gene sequencing to assess the sinonasal microbiome and 1 used 16s‐rRNA PhyloChip analysis. Seven studies used Sino‐Nasal Outcome Test scores, 1 applied another CRS symptom metric, and 1 used need for additional procedures/antibiotics as the primary clinical outcome. Three studies suggest that baseline abundance of phylum Actinobacteria (specifically genus Corynebacterium) was predictive of better surgical outcome. One study found C. tuberculostearicum was positively correlated with symptom severity. Another study revealed genus Escherichia was overrepresented in CRS and had positive correlation with increased symptom scores. In addition, 1 study identified Acinetobacter johnsonii to be associated with improvement in symptom scores while supporting Pseudomonas aeruginosa as having a negative impact on quality of life. Conclusion Microbiome data are varied in their association with clinical outcomes of CRS patients. Further research is required to identify if predominance of certain microbes within the microbiome is predictive of CRS patients’ outcomes.
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Affiliation(s)
- James C Wang
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Charles A Moore
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Madison V Epperson
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Ahmad R Sedaghat
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
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24
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Yamanishi S, Pawankar R. Current advances on the microbiome and role of probiotics in upper airways disease. Curr Opin Allergy Clin Immunol 2020; 20:30-35. [DOI: 10.1097/aci.0000000000000604] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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25
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Kumpitsch C, Koskinen K, Schöpf V, Moissl-Eichinger C. The microbiome of the upper respiratory tract in health and disease. BMC Biol 2019; 17:87. [PMID: 31699101 PMCID: PMC6836414 DOI: 10.1186/s12915-019-0703-z] [Citation(s) in RCA: 226] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 02/08/2023] Open
Abstract
The human upper respiratory tract (URT) offers a variety of niches for microbial colonization. Local microbial communities are shaped by the different characteristics of the specific location within the URT, but also by the interaction with both external and intrinsic factors, such as ageing, diseases, immune responses, olfactory function, and lifestyle habits such as smoking. We summarize here the current knowledge about the URT microbiome in health and disease, discuss methodological issues, and consider the potential of the nasal microbiome to be used for medical diagnostics and as a target for therapy.
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Affiliation(s)
- Christina Kumpitsch
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Kaisa Koskinen
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Veronika Schöpf
- Institute of Psychology, University of Graz, Universitaetsplatz 2, 8010 Graz, Austria
- BioTechMed-Graz, Mozartgasse 12/II, 8010 Graz, Austria
- Present address: Medical University Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Christine Moissl-Eichinger
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
- BioTechMed-Graz, Mozartgasse 12/II, 8010 Graz, Austria
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26
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Sub-Inhibitory Clindamycin and Azithromycin reduce S. aureus Exoprotein Induced Toxicity, Inflammation, Barrier Disruption and Invasion. J Clin Med 2019; 8:jcm8101617. [PMID: 31590226 PMCID: PMC6832279 DOI: 10.3390/jcm8101617] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/19/2019] [Accepted: 09/27/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Chronic rhinosinusitis (CRS) is defined as a chronic inflammation of the nose and paranasal sinus mucosa associated with relapsing infections—particularly with S. aureus. Long-term treatments with protein synthesis inhibitor antibiotics have been proposed to reduce inflammation in the context chronic severe inflammatory airway pathologies, including CRS. This study assessed the effect of subinhibitory clindamycin and azithromycin on S. aureus exoprotein induced inflammation, toxicity and invasiveness. Methods: S. aureus ATCC51650 and two clinical isolates grown in planktonic and biofilm form were treated with subinhibitory clindamycin and azithromycin. Exoproteins were collected and applied to primary human nasal epithelial cells (HNECs) in monolayers and at air-liquid interface. This was followed by lactate dehydrogenase (LDH), enzyme-linked immunosorbent assay (ELISA), Transepithelial Electrical Resistance (TEER) and paracellular permeability assays to assess the effect on cell toxicity, inflammatory cytokine production and mucosal barrier structure and function, respectively. The effect of these treatments was tested as well on the S. aureus invasiveness of HNECs. Results: Subinhibitory clindamycin reduced S. aureus exoprotein production in planktonic and biofilm form, thereby blocking exoprotein-induced toxicity, reversing its detrimental effects on mucosal barrier structure and function and modulating its inflammatory properties. Sub-inhibitory azithromycin had similar effects—albeit to a lesser extent. Furthermore, clindamycin—but not azithromycin—treated S. aureus lost its invasive capacity of HNECs. Conclusion: Subinhibitory clindamycin and azithromycin reduce S. aureus exoprotein production, thereby modulating the inflammatory cascade by reducing exoprotein-induced toxicity, inflammation, mucosal barrier disruption and invasiveness.
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27
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Vandelaar LJ, Hanson B, Marino M, Yao WC, Luong AU, Arias CA, Ramakrishnan V, Citardi MJ. Analysis of Sinonasal Microbiota in Exacerbations of Chronic Rhinosinusitis Subgroups. OTO Open 2019; 3:2473974X19875100. [PMID: 31555757 PMCID: PMC6749786 DOI: 10.1177/2473974x19875100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/20/2019] [Indexed: 11/17/2022] Open
Abstract
Objective Microbiome analyses now allow precise determination of the sinus microbiota of patients with exacerbations of chronic rhinosinusitis (CRS). The aim of this report is to describe the sinus microbiota of acute exacerbations in CRS clinical subgroups (with nasal polyps [CRSwNP], without nasal polyps [CRSsNP], and allergic fungal rhinosinusitis [AFRS]). Study Design Retrospective chart review. Setting Tertiary rhinology practice. Subjects and Methods A retrospective review was performed of all patients whose sinus microbiota were assayed via a commercially available microbiome technology during an acute CRS exacerbation during the 2-year period ending December 31, 2016. All samples were sinus aspirates collected under endoscopic visualization in clinic. Results Samples from a total of 134 patients (65 CRSsNP, 55 CRSwNP, and 14 AFRS) were reviewed. The observed richness (number of taxa >2% relative abundance) ranged between 1 and 11 taxa, with an average of 3 taxa per specimen. The most common bacteria in all groups were Staphylococcal spp (including Staphylococcus aureus), Streptococcus spp, Pseudomonas spp, and Escherichia spp. S aureus had an increased prevalence in CRSsNP and AFRS as compared with CRSwNP. Otherwise, the sinus microbiota were markedly similar among all 3 clinical subgroups. Conclusions Many bacterial types are identified during acute CRS exacerbation according to DNA-based detection techniques. Bacterial richness was remarkably low in all samples. Few differences in the patterns among clinical subgroups were observed. Further investigation is warranted to determine the clinical significance of these observations and their role in current clinical algorithms.
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Affiliation(s)
- Laura J Vandelaar
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Blake Hanson
- Department of Epidemiology, Human Genetics & Environment Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA.,Center for Antimicrobial Resistance and Microbial Genomics, Division of Infectious Diseases, Department of Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Michael Marino
- Department of Otorhinolaryngology, Mayo Clinic, Phoenix, Arizona, USA
| | - William C Yao
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Amber U Luong
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Cesar A Arias
- Department of Epidemiology, Human Genetics & Environment Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA.,Center for Antimicrobial Resistance and Microbial Genomics, Division of Infectious Diseases, Department of Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Vijay Ramakrishnan
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Martin J Citardi
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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28
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Bennett C, Ramezanpour M, Cooksley C, Vreugde S, Psaltis AJ. Kappa-carrageenan sinus rinses reduce inflammation and intracellular Staphylococcus aureus infection in airway epithelial cells. Int Forum Allergy Rhinol 2019; 9:918-925. [PMID: 31162892 DOI: 10.1002/alr.22360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/29/2019] [Accepted: 05/09/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a common disease, often refractory to conventional antimicrobial treatment. In this study we investigate the antimicrobial and anti-inflammatory effects of adding kappa-carrageenan to a commercially available sinus rinse. METHODS Kappa-carrageenan was added to Flo CRS and Flo Sinus Care sinus rinses and applied directly to air-liquid interface cultured primary human nasal epithelial cells (HNECs) from 10 CRS patients. Inflammatory markers were measured using enzyme-linked immunosorbent assay. Kappa-carrageenan-supplemented sinus rinses were applied to human bronchial epithelial cells (HBEs) in the presence of different Staphylococcus aureus strains to observe the effect on intracellular infection rates. RESULTS Flo Sinus Care with kappa-carrageenan rinse solutions resulted in a marked reduction of interleukin-6 (IL-6) production by HNECs from CRS patients (p = 0.007). Both Flo CRS and Flo Sinus Care rinses significantly reduced the S aureus intracellular infection of HBEs (p < 0.0001). The addition of kappa-carrageenan to both Flo CRS and Flo Sinus Care rinses further reduced the intracellular infection rate by an average of 2%. CONCLUSIONS The commonly used sinus irrigation product Flo Sinus Care with added kappa-carrageenan reduces IL-6 production by HNECs in vitro. Flo CRS and Flo Sinus Care rinses significantly reduced S aureus intracellular infection rates of HBE cells. Our findings may have clinical relevance for CRS patient management.
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Affiliation(s)
- Catherine Bennett
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Mahnaz Ramezanpour
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Clare Cooksley
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Sarah Vreugde
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Alkis James Psaltis
- Department of Surgery, Otorhinolaryngology-Head and Neck Surgery, The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
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29
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Mezouar S, Chantran Y, Michel J, Fabre A, Dubus JC, Leone M, Sereme Y, Mège JL, Ranque S, Desnues B, Chanez P, Vitte J. Microbiome and the immune system: From a healthy steady-state to allergy associated disruption. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.humic.2018.10.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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30
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Tertiary lymphoid organs: A novel target in patients with chronic rhinosinusitis. J Allergy Clin Immunol 2018; 142:1673-1676. [DOI: 10.1016/j.jaci.2018.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/10/2018] [Accepted: 07/20/2018] [Indexed: 11/22/2022]
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31
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Sivasubramaniam R, Douglas R. The microbiome and chronic rhinosinusitis. World J Otorhinolaryngol Head Neck Surg 2018; 4:216-221. [PMID: 30506054 PMCID: PMC6251963 DOI: 10.1016/j.wjorl.2018.08.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 12/12/2022] Open
Abstract
Chronic rhinosinusitis (CRS) is a multifactorial condition in which the microbiota plays a pathogenic role. The nature of the interaction between the microbiota and the local immune system is very complex and has not been fully elucidated. Recent improvements in the microbiological techniques have greatly advanced our understanding of the complex nature of this interaction. This paper summarizes the current state of the rapidly evolving research on this subject. Defining the nature of the role of the microbiota in CRS is important because of the associated therapeutic implications.
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Affiliation(s)
- Rahuram Sivasubramaniam
- Department of Otorhinolaryngology Head and Neck Surgery, Auckland City Hospital, Park Road, Grafton, Auckland 1023, New Zealand
| | - Richard Douglas
- Department of Surgery, The University of Auckland, Grafton, Auckland, New Zealand
- Corresponding author.
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32
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Kuhar HN, Tajudeen BA, Mahdavinia M, Heilingoetter A, Ganti A, Gattuso P, Ghai R, Batra PS. Relative abundance of nasal microbiota in chronic rhinosinusitis by structured histopathology. Int Forum Allergy Rhinol 2018; 8:1430-1437. [PMID: 30240151 DOI: 10.1002/alr.22192] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/07/2018] [Accepted: 07/09/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is an inflammatory disease process with several different phenotypes. Recent data has shown that CRS phenotypes maintain distinct nasal microbiota that may predict surgical outcomes. Nasal microbiota and structured histopathologic reporting have the potential to further differentiate subtypes and provide additional insight into the pathophysiology of CRS. METHODS Sinus swabs collected during functional endoscopic sinus surgery (FESS) were studied by polymerase chain reaction analysis of 16S ribosomal RNA. A structured histopathology report of 13 variables was utilized to analyze sinus tissue removed during FESS. Histopathology variables and relative abundance of nasal microbiota were compared among CRS patients. RESULTS A total of 51 CRS patients who underwent FESS were included. Relative abundance of the Firmicutes phylum in nasal microbiota of CRS patients was associated with presence of neutrophilic infiltrate (27.47 ± 44.75 vs 9.21 ± 11.84, p < 0.029), presence of mucosal ulceration (47.67 ± 45.52 vs 13.27 ± 26.48, p < 0.041), presence of squamous metaplasia (5562.70 ± 2715.66 vs 3563.73 ± 2580.84, p < 0.035), and absence of Charcot-Leyden crystals (5423.00 ± 3320.57 vs 679.94 ± 1653.66, p < 0.001). Relative abundance of the Bacteroidetes phylum in nasal microbiota of CRS patients was associated with increased severity of inflammatory degree (p < 0.004) and presence of mucosal ulceration (p < 0.004). CONCLUSION Distinct histopathologic features of CRS are associated with relative abundance of nasal microbiota phyla, specifically Firmicutes and Bacteroidetes. These findings contribute to the growing body of literature on microbiota in sinonasal disease and may have important implications for understanding pathophysiologic mechanisms of CRS subtypes and disease management.
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Affiliation(s)
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush Sinus Program, Rush University Medical Center, Chicago, IL
| | - Mahboobeh Mahdavinia
- Division of Allergy/Immunology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | | | | | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, Chicago, IL
| | - Ritu Ghai
- Department of Pathology, Rush University Medical Center, Chicago, IL
| | - Pete S Batra
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush Sinus Program, Rush University Medical Center, Chicago, IL
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33
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Copeland E, Leonard K, Carney R, Kong J, Forer M, Naidoo Y, Oliver BGG, Seymour JR, Woodcock S, Burke CM, Stow NW. Chronic Rhinosinusitis: Potential Role of Microbial Dysbiosis and Recommendations for Sampling Sites. Front Cell Infect Microbiol 2018. [PMID: 29541629 PMCID: PMC5836553 DOI: 10.3389/fcimb.2018.00057] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is an inflammatory condition that affects up to 12% of the human population in developed countries. Previous studies examining the potential role of the sinus bacterial microbiota within CRS infections have found inconsistent results, possibly because of inconsistencies in sampling strategies. The aim of this study was to determine whether the sinus microbiome is altered in CRS and additionally if the middle meatus is a suitable representative site for sampling the sinus microbiome. Swab samples were collected from 12 healthy controls and 21 CRS patients, including all eight sinuses for CRS patients and between one and five sinuses for control subjects. The left and right middle meatus and nostril swabs were also collected. Significant differences in the sinus microbiomes between CRS and control samples were revealed using high-throughput 16S rRNA gene sequencing. The genus Escherichia was over-represented in CRS sinuses, and associations between control patients and Corynebacterium and Dolosigranulum were also identified. Comparisons of the middle meatuses between groups did not reflect these differences, and the abundance of the genus Escherichia was significantly lower at this location. Additionally, intra-patient variation was lower between sinuses than between sinus and middle meatus, which together with the above results suggests that the middle meatus is not an effective representative sampling site.
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Affiliation(s)
- Elizabeth Copeland
- The School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Katherine Leonard
- Sydney Centre for Ear Nose and Throat, Frenchs Forest, Sydney, NSW, Australia
| | - Richard Carney
- The Climate Change Cluster, University of Technology Sydney, Sydney, NSW, Australia
| | - Justin Kong
- Department of Otorhinolaryngology, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia
| | - Martin Forer
- Department of Otorhinolaryngology, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia
| | - Yuresh Naidoo
- Department of Otorhinolaryngology, Concord Hospital, University of Sydney, Sydney, NSW, Australia
| | - Brian G G Oliver
- The School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Justin R Seymour
- The Climate Change Cluster, University of Technology Sydney, Sydney, NSW, Australia
| | - Stephen Woodcock
- The Climate Change Cluster, University of Technology Sydney, Sydney, NSW, Australia
| | - Catherine M Burke
- The School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Nicholas W Stow
- Department of Otorhinolaryngology, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
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34
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Cervin AU. The Potential for Topical Probiotic Treatment of Chronic Rhinosinusitis, a Personal Perspective. Front Cell Infect Microbiol 2018; 7:530. [PMID: 29379772 PMCID: PMC5770906 DOI: 10.3389/fcimb.2017.00530] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/18/2017] [Indexed: 12/15/2022] Open
Abstract
This review describes the rationale for topical probiotic intervention, the obstacles we are facing and a strategy for future research in the use of probiotics to modify CRS symptoms and disease expression. Recent advances in molecular microbiology has revealed a plethora of microbial DNA in the nasal cavity and sinuses of healthy subjects as well as in chronic sinusitis (CRS) patients. An infection is today rather seen as an imbalance between the commensal microbiome and the bacterial pathogens, resulting in a reduction in commensal bacterial diversity, combined with an increase in the growth of microbes eliciting an inflammatory response. This will in turn lead to the clinical symptoms of sinusitis. Probiotics (microorganisms that confer a health benefit) can be used either as a form of living antibiotics treatment, or as an immune-modulatory intervention. Topical probiotics, which is the focus of this review, have shown efficacy in a limited number of trials in otitis media and tonsillitis, but to date not in CRS. Although bacterial interference capacity against pathogens can be determined in in vitro experiments, it may not translate to a health benefit. This limits the role of laboratory research in identifying probiotic strains with a clinical benefit. To gain more clinical experience without further delay, I recommend future research to focus on empirical clinical trials in well-defined CRS patient populations and study the underlying mechanisms in more detail once a clinical benefit has been established.
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Affiliation(s)
- Anders U Cervin
- Faculty of Medicine, The Garnett Passe and Rodney Williams Memorial Foundation Chair in Otolaryngology, (Rhinology), University of Queensland, Brisbane, QLD, Australia.,Department of Otolaryngology, University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia.,Department of Otolaryngology, Head and Neck Surgery, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.,Royal Brisbane and Women's Hospital Clinical Unit, Herston, QLD, Australia
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