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The Nasal and Sinus Microbiome in Health and Disease


There has been great interest in unraveling the complex inter-relationships between microbes and humans as they relate to human health and disease. This review will focus on recent advances in the appreciation and understanding of these relationships in terms of the upper respiratory tract, specifically the nose and paranasal sinuses.

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Coagulase-negative Staphylococcus


Chronic rhinosinusitis


Confocal scanning laser microscopy


Fluorescence in situ hybridization


Healthy control(s)


Human beta defensin


Intraepithelial Staphyloccus aureus


Methicillin-resistant Staphylococcus aureus


Nitric oxide


Operational taxonomic unit


Scanning electron microscopy


A bitter taste receptor


A bitter taste receptor polymorphism


Transmission electron microscopy


Toll-like receptor


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Lemon KP, Klepac-Ceraj V, Schiffer HK, Brodie EL, Lynch SV, Kolter R. Comparative analyses of the bacterial microbiota of the human nostril and oropharynx. mBio. 2010;1(3):e00129-10. This is a study of the bacterial microbiota of the nostril and posterior wall of the oropharynx from 7 healthy adults using a 16S rRNA gene microarray (PhyloChip) and 16S rRNA gene clone libraries showing that the PhyloChip is orders of magnitude more sensitive in its ability to identify diversity and for detecting low abundance taxa.

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  2. Nikolaki S, Tsiamis G. Microbial diversity in the era of omic technologies. BioMed Res Int. 2013;2013:958719. This is a excellent review of molecular tools used to study microbial communities.

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  4. Ecker DJ, Sampath R, Massire C, Blyn LB, Hall TA, Eshoo MW, et al. Ibis T5000: a universal biosensor approach for microbiology. Nat Rev Microbiol. 2008;6(7):553–8. This study described the Ibis T5000, a platform that couples nucleic acid amplification to high-performance electrospray ionization mass spectrometry and base-composition analysis to identify pathogens in clinical and environmental samples.

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  7. The Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature. 2012;486(7402):207–14. This paper summarized the Human Microbiome Project’s analysis of the largest cohort and set of distinct, clinically relevant body habitats so far and delineating the range of structural and functional configurations in the microbial communities of a healthy population.

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  8. Gillespie JJ, Wattam AR, Cammer SA, Gabbard JL, Shukla MP, Dalay O, et al. PATRIC: the comprehensive bacterial bioinformatics resource with a focus on human pathogenic species. Infect Immun. 2011;79(11):4286–98. This paper described the Pathosystems Resource Integration Center (PATRIC), a genomics-centric relational database and bioinformatics resource that provides scientists with (i) a comprehensive bacterial genomics database, (ii) a plethora of associated data relevant to genomic analysis, and (iii) an extensive suite of computational tools and platforms for bioinformatics analysis.

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  9. den Heijer CD, van Bijnen EM, Paget WJ, Pringle M, Goossens H, Bruggeman CA, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S aureus, in nine European countries: a cross-sectional study. Lancet Infect Dis. 2013;13(5):409–15. This study examined the prevalence of nasal S aureus carriage and antibiotic resistance, including meticillin-resistant S aureus (MRSA), in healthy patients across nine European countries using nasal swabs.

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  10. Frank DN, Feazel LM, Bessesen MT, Price CS, Janoff EN, Pace NR. The human nasal microbiota and Staphylococcus aureus carriage. PLoS One. 2010;5(5):e10598. This study examined nasal specimens from 5 healthy adults and hospitalized patients (including 26 S aureus carriers and 16 non-carriers) using 16S rRNA sequences and demonstrated a negative association between S aureus, S epidermidis, and other groups suggests microbial competition during colonization of the nares.

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  14. Abreu NA, Nagalingam NA, Song Y, Roediger FC, Pletcher SD, Goldberg AN, et al. Sinus microbiome diversity depletion and Corynebacterium tuberculostearicum enrichment mediates rhinosinusitis. Sci Transl Med. 2012;4(151):151ra24. This study compared sinus brushings from 10 healthy non-CRS controls and 7 CRS patients using a phylogenetic microarray and identified a protective role for the taxon Lactobacillales (that includes Lactobacillus sakei) and a pathogenic role for Corynebacteriaceae (including the organism Corynebacteium tuberculostericum) in CRS.

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  16. Psaltis AJ, Ha KR, Beule AG, Tan LW, Wormald PJ. Confocal scanning laser microscopy evidence of biofilms in patients with chronic rhinosinusitis. Laryngoscope. 2007;117(7):1302–6. This study investigate biofilm presence in 38 CRS patients and 9 non-CRS controls using CSLM and identified biofilm in 44 % of CRS patients and none of the non-CRS controls.

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  26. Boase S, Foreman A, Cleland E, Tan L, Melton-Kreft R, Pant H, et al. The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection. BMC Infect Dis. 2013;13:210. This study used multiple techniques to characterize bacterial and fungal unvolvement of sinonasal mucosa in CRS patients and controls including conventional culture, PCR coupled with electrospray ionization time-of-flight mass spectrometry, and FISH and found an increased abundance of S aureus in CRS.

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Michael T. Wilson and Daniel L. Hamilos report no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by the authors.

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Correspondence to Daniel L. Hamilos.

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This article is part of the Topical Collection on Rhinosinusitis

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Wilson, M.T., Hamilos, D.L. The Nasal and Sinus Microbiome in Health and Disease. Curr Allergy Asthma Rep 14, 485 (2014).

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