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Bacteria, Viruses and Fungi in Healthy and Diseased Paranasal Sinuses

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Contemporary Rhinology: Science and Practice

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Abstract

Technological advancements in the field of microbiology have led to significant progress in our understanding of bacteria, viruses and fungi in healthy and diseased paranasal sinuses. This chapter will cover: (1) the role of microbes in health and various sinonasal conditions and the relationship between the microbiota and antimicrobial treatments; (2) the various laboratory techniques utilised to investigate microbes (including culture, fluorescence in situ hybridisation and sequencing approaches); and (3) current limitations and areas of controversy in the literature, particularly with regards to culture and sequencing studies of the sinonasal microbiota. Modern sequencing approaches have led to novel hypotheses on the role of the microbiota in health and various diseases. The microbial community in healthy paranasal sinuses has multiple functions, including contributing to maintaining the mucosal barrier and effective local immune responses. However, in conditions such as chronic rhinosinusitis, the role of these microbes remain unclear. Single pathogen, biofilm and microbial dysbiosis hypotheses will be discussed. The understanding of these pathogenic mechanisms is currently incomplete and limited by the resource-intensive nature of modern laboratory methods.

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Key References

  • Arild Danielsen K, Eskeland Ø, Fridrich-Aas K, Cecilie Orszagh V, Bachmann-Harildstad G, Burum-Auensen E. Bacterial biofilms in chronic rhinosinusitis; distribution and prevalence. Acta Otolaryngol. 2016;136:109–12.

    Article  PubMed  Google Scholar 

  • Biswas K, Cavubati R, Gunaratna S, Hoggard M, Waldvogel-Thurlow S, Hong J, Chang K, Mackenzie BW, Taylor MW, Douglas RG. Comparison of subtyping approaches and the underlying drivers of microbial signatures for chronic rhinosinusitis. MSphere. 2019;4

    Google Scholar 

  • Cleland EJ, Bassiouni A, Vreugde S, Wormald P-J. The bacterial microbiome in chronic rhinosinusitis: richness, diversity, postoperative changes, and patient outcomes. Am J Rhinol Allergy. 2016;30:37–43.

    Article  PubMed  Google Scholar 

  • Cope EK, Goldberg AN, Pletcher SD, Lynch SV. Compositionally and functionally distinct sinus microbiota in chronic rhinosinusitis patients have immunological and clinically divergent consequences. Microbiome. 2017;5:1–16.

    Article  Google Scholar 

  • De Boeck I, Wittouck S, Martens K, Claes J, Jorissen M, Steelant B, van den Broek MF, Seys SF, Hellings PW, Vanderveken OM. Anterior nares diversity and pathobionts represent sinus microbiome in chronic rhinosinusitis. MSphere. 2019;4

    Google Scholar 

  • Gelber JT, Cope EK, Goldberg AN, Pletcher SD. Evaluation of Malassezia and common fungal pathogens in subtypes of chronic rhinosinusitis. Int Forum Allergy Rhinol. 2016;2016:950–5.

    Article  Google Scholar 

  • Goggin RK, Bennett CA, Bialasiewicz S, Vediappan RS, Vreugde S, Wormald PJ, Psaltis AJ. The presence of virus significantly associates with chronic rhinosinusitis disease severity. Allergy. 2019;74:1569.

    Article  PubMed  Google Scholar 

  • Hoggard M, Biswas K, Zoing M, Wagner Mackenzie B, Taylor MW, Douglas RG. Evidence of microbiota dysbiosis in chronic rhinosinusitis. Int Forum Allergy Rhinol. 2017;3:230–9.

    Article  Google Scholar 

  • Hoggard M, Vesty A, Wong G, Montgomery JM, Fourie C, Douglas RG, Biswas K, Taylor MW. Characterizing the human mycobiota: a comparison of small subunit rRNA, ITS1, ITS2, and large subunit rRNA genomic targets. Front Microbiol. 2018;9:2208.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jain R, Hoggard M, Biswas K, Zoing M, Jiang Y, Douglas R. Changes in the bacterial microbiome of patients with chronic rhinosinusitis after endoscopic sinus surgery. Int Forum Allergy Rhinol. 2017;7:7–15.

    Article  PubMed  Google Scholar 

  • Kaspar U, Kriegeskorte A, Schubert T, Peters G, Rudack C, Pieper DH, Wos-Oxley M, Becker K. The culturome of the human nose habitats reveals individual bacterial fingerprint patterns. Environ Microbiol. 2016;18:2130–42.

    Article  CAS  PubMed  Google Scholar 

  • Koutsourelakis I, Halderman A, Khalil S, Hittle LE, Mongodin EF, Lane AP. Temporal instability of the post-surgical maxillary sinus microbiota. BMC Infect Dis. 2018;18:1–12.

    Article  Google Scholar 

  • Lucas SK, Yang R, Dunitz JM, Boyer HC, Hunter RC. 16S rRNA gene sequencing reveals site-specific signatures of the upper and lower airways of cystic fibrosis patients. J Cyst Fibros. 2018;17:204–12.

    Article  CAS  PubMed  Google Scholar 

  • Mahdavinia M, Keshavarzian A, Tobin MC, Landay A, Schleimer RP. A comprehensive review of the nasal microbiome in chronic rhinosinusitis (CRS). Clin Exp Allergy. 2016;46:21–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU, Poetker DM, Soler Z, Welch KC, Wise SK. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021;11:213–739.

    Article  PubMed  Google Scholar 

  • Schmidt F, Meyer T, Sundaramoorthy N, Michalik S, Surmann K, Depke M, Dhople V, Salazar MG, Holtappels G, Zhang N. Characterization of human and Staphylococcus aureus proteins in respiratory mucosa by in vivo-and immunoproteomics. J Proteomics. 2017;155:31–9.

    Article  CAS  PubMed  Google Scholar 

  • Van Zele T, Holtappels G, Gevaert P, Bachert C. Differences in initial immunoprofiles between recurrent and nonrecurrent chronic rhinosinusitis with nasal polyps. Am J Rhinol Allergy. 2014;28:192–8.

    Article  PubMed  Google Scholar 

  • Wagner Mackenzie B, Waite DW, Hoggard M, Douglas RG, Taylor MW, Biswas K. Bacterial community collapse: a meta-analysis of the sinonasal microbiota in chronic rhinosinusitis. Environ Microbiol. 2017;19:381–92.

    Article  CAS  PubMed  Google Scholar 

  • Wagner Mackenzie B, West AG, Waite DW, Lux CA, Douglas RG, Taylor MW, Biswas K. A novel description of the human sinus archaeome during health and chronic rhinosinusitis. Front Cell Infect Microbiol. 2020;10:398.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wandell GM, Miller C, Rathor A, Wai TH, Guyer RA, Schmidt RA, Turner JH, Hwang PH, Davis GE, Humphreys IM. A multi-institutional review of outcomes in biopsy-proven acute invasive fungal sinusitis. Int Forum Allergy Rhinol. 2018;2018:1459–68.

    Article  Google Scholar 

  • Wos-Oxley ML, Chaves-Moreno D, Jáuregui R, Oxley AP, Kaspar U, Plumeier I, Kahl S, Rudack C, Becker K, Pieper DH. Exploring the bacterial assemblages along the human nasal passage. Environ Microbiol. 2016;18:2259–71.

    Article  CAS  PubMed  Google Scholar 

  • Zhang Z, Adappa ND, Chiu AG, Doghramji LJ, Cohen NA, Palmer JN. Biofilm-forming bacteria and quality of life improvement after sinus surgery. Int Forum Allergy Rhinol. 2015;5:643–9.

    Article  PubMed  Google Scholar 

  • Zhao YC, Bassiouni A, Tanjararak K, Vreugde S, Wormald PJ, Psaltis AJ. Role of fungi in chronic rhinosinusitis through ITS sequencing. Laryngoscope. 2018;128:16–22.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors thank Dr Kristi Biswas for her invaluable microbiology expertise in reviewing and editing this chapter.

Tary Yin is supported by the Garnett Passe & Rodney Williams Memorial Foundation Academic Surgeon-Scientist Research Scholarship. The authors have no other sources of funding to declare.

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  1. Department of Surgery, University of Auckland, Auckland, New Zealand

    Tary Yin & Raymond Kim

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Correspondence to Raymond Kim .

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Editors and Affiliations

  1. Liverpool Head and Neck Centre, Liverpool University Hospitals, Foundation Trust, Liverpool, UK

    Andrew C. Swift

  2. Otolaryngology, Freeman Hospital, Newcastle upon Tyne, Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

    Sean Carrie

  3. Department of Otolaryngology, Tata Memorial Hospital, Mumbai, Maharashtra, India

    Christopher de Souza

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Yin, T., Kim, R. (2023). Bacteria, Viruses and Fungi in Healthy and Diseased Paranasal Sinuses. In: Swift, A.C., Carrie, S., de Souza, C. (eds) Contemporary Rhinology: Science and Practice. Springer, Cham. https://doi.org/10.1007/978-3-031-28690-2_9

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