Microbiome Dynamics in Chronic Rhinosinusitis
Summary
Chronic rhinosinusitis (CRS) is a persistent inflammatory disorder of the sinonasal mucosa characterised by recurrent nasal congestion, impaired olfaction and facial pressure. Emerging evidence implicates the sinonasal microbiome—a complex ecosystem of bacteria, fungi and viruses—in both the onset and persistence of CRS. In health, a balanced community of commensal species such as Corynebacterium and Propionibacterium contributes to mucosal homeostasis, whereas CRS is marked by reduced microbial diversity, overgrowth of potential pathogens such as Staphylococcus aureus and altered community function. Disruption of the epithelial barrier, impairment of mucociliary clearance and formation of bacterial biofilms perpetuate inflammation and hinder treatment. Stratification of CRS subtypes by microbial profile and host immune response has revealed distinct phenotypes, suggesting that targeted modulation of the microbiome could inform personalised therapeutic strategies and improve patient outcomes worldwide.
Research from Nature Portfolio
Recent studies have demonstrated that patients with nasal polyps exhibit a marked shift in microbial composition compared to healthy controls, with significant enrichment of Haemophilus influenzae and Staphylococcus aureus and depletion of beneficial Propionibacterium acnes. These dysbiotic changes correlate with elevated mucosal IgE and type 2 cytokines, contributing to polyp growth and steroid resistance. Co-culture experiments indicate competitive interactions among these taxa, highlighting how pathogen overrepresentation may undermine commensal populations and exacerbate inflammation.
Microbiome Dynamics in Chronic Rhinosinusitis publication trend
The graph below shows the total number of articles in microbiome dynamics in chronic rhinosinusitis across all publications each year (not limited to Nature Index journals).
Technical terms
Microbiome: The community of microorganisms and their collective genomes in a specific environment.
Dysbiosis: Disruption or imbalance of the normal microbial community associated with disease.
Biofilm: A structured microbial community embedded in a protective extracellular matrix.
Mucociliary clearance: The mechanism by which cilia and mucus transport inhaled particles and pathogens out of the airways.
Epithelial barrier: The layer of cells lining the sinuses that prevents pathogen invasion and regulates immunity.
Type 2 inflammation: An immune response characterised by cytokines such as IL-4, IL-5 and IL-13, common in allergic conditions.
References
- The destruction of mucosal barriers, epithelial remodeling, and impaired mucociliary clearance: possible pathogenic mechanisms of Pseudomonas aeruginosa and Staphylococcus aureus in chronic rhinosinusitis. Cell Communication and Signaling (2023).
- The nasal microbiome in patients suffering from non-steroidal anti-inflammatory drugs-exacerbated respiratory disease in absence of corticosteroids. Frontiers in Immunology (2023).
- Chronic Rhinosinusitis—Microbiological Etiology, Potential Genetic Markers, and Diagnosis. International Journal of Molecular Sciences (2024).
- Compositionally and functionally distinct sinus microbiota in chronic rhinosinusitis patients have immunological and clinically divergent consequences. Microbiome (2017).
- Chronic rhinosinusitis with nasal polyps is characterized by dysbacteriosis of the nasal microbiota. Scientific Reports (2018).
- The pathophysiological role of bacterial biofilms in chronic sinusitis. European Archives of Oto-Rhino-Laryngology (2015).
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