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Therapy of Sinonasal Microbiome in CRS: A Critical Approach

  • Rhinosinusitis (J Mullol, Section Editor)
  • Published:
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Abstract

Purpose of Review

Perturbations in local microbiota have been demonstrated in many chronic inflammatory diseases including chronic rhinosinusitis (CRS). The purpose of this paper is to review the latest microbiome research as it pertains to CRS and establish whether there is any evidence supporting the microbiome hypothesis for CRS. Treatment factors that may influence the sinonasal microbiome as well as the role of probiotics are also discussed.

Recent Findings

Despite significant heterogeneity in study design, tissue sampling, processing and bioinformatics analysis, consistent findings have emerged from the recent literature. Healthy individuals and CRS patients have similar overall bacterial burden of disease and share many common phylum. CRS patients, however, routinely show reductions in markers of biodiversity. Both medical and surgical treatments appear to influence the sinonasal microbiome, with certain bacterial strains associated with better treatment outcomes.

Summary

The presence of microbial dysbiosis in CRS is now supported by numerous studies. Whether this dysbiosis is a cause or rather an association of the disease process still remains unclear. Although probiotic therapies show early promise, much larger studies are required to establish their real role as a treatment for CRS.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, The University of Adelaide, South Australia, 28 Woodville Road, Woodville, SA, 5011, Australia

    Alkis J. Psaltis & Peter-John Wormald

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  1. Alkis J. Psaltis
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  2. Peter-John Wormald
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Correspondence to Alkis J. Psaltis.

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Conflict of Interest

Dr. Psaltis reports personal fees from Smith and Nephew, from Medtronic, from ENT technologies, and Aerin Medical Technologies, none of these relevant to this manuscript. Dr. Wormald reports no conflicts of interest relevant to this manuscript.

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

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This article is part of the Topical Collection on Rhinosinusitis

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Psaltis, A.J., Wormald, PJ. Therapy of Sinonasal Microbiome in CRS: A Critical Approach. Curr Allergy Asthma Rep 17, 59 (2017). https://doi.org/10.1007/s11882-017-0726-x

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