Association of the sinonasal bacterial microbiome with clinical outcomes in chronic rhinosinusitis: a systematic review

Wang, James C.; Moore, Charles A.; Epperson, Madison V.; Sedaghat, Ahmad R.

doi:10.1002/alr.22524

Cited by 12 publications

(12 citation statements)

References 48 publications

(203 reference statements)

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“…Emerging evidence shows that different microbiome varied in their associations with clinical symptoms of patients with chronic rhinosinusitis ( Wang et al, 2020 ). Few studies have explored the changes in salivary microbiomes of HNC patients with HNC-related symptoms.…”

Section: Discussionmentioning

confidence: 99%

Study on the Salivary Microbial Alteration of Men With Head and Neck Cancer and Its Relationship With Symptoms in Southwest China

Zuo

Zhao

et al. 2020

Front. Cell. Infect. Microbiol.

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This study explored the association between oral microbes and head and neck cancer (HNC) as well as symptoms related to patients with HNC before surgical treatment. Fiftysix patients with HNC and 64 matched healthy controls were recruited from West China hospital in Southwest China. The demographic, clinical, and symptom data were collected. Salivary samples were collected to determine the microbial characteristics using 16S rRNA gene sequencing. Patients with HNC presented increased Capnocytophaga abundances. The oral microbial markers as Capnocytophaga (area under the curve=0.81) achieved a high classification power between the HNC patients and healthy controls. Moreover, using Capnocytophaga in conjunction with symptom of voice/speech difficulty achieved an overall predicting accuracy of 92.5% comparing with using Capnocytophaga alone (79.2% accuracy) in distinguishing the HNC patients from healthy controls. Salivary microbial profiles and HNC symptoms may be potential biomarkers for HNC screening.

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Section: Discussionmentioning

confidence: 99%

Study on the Salivary Microbial Alteration of Men With Head and Neck Cancer and Its Relationship With Symptoms in Southwest China

Zuo

Zhao

et al. 2020

Front. Cell. Infect. Microbiol.

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“…[6][7][8][9][10] Multiple hypotheses have been proposed to explain the potential mechanism of Th1-Th2 imbalance, leading to the development of rhinitis, but so far the precise influence of biodiversity changes in CRS remains unexplained. [22][23][24][25][26][27] Nevertheless, increased bacterial dysbiosis, characterized by a reduction in microbial diversity, has been reported in patients with CRS compared with healthy patients.…”

Section: Discussionmentioning

confidence: 99%

“…While CRS is by definition considered to be driven by chronic inflammation of the nasal mucosa, the role of dysbiosis was raised as a potential driving factor of the inflammatory mechanisms . Multiple hypotheses have been proposed to explain the potential mechanism of Th1-Th2 imbalance, leading to the development of rhinitis, but so far the precise influence of biodiversity changes in CRS remains unexplained . Nevertheless, increased bacterial dysbiosis, characterized by a reduction in microbial diversity, has been reported in patients with CRS compared with healthy patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of an Intranasal Corticosteroid on Quality of Life and Local Microbiome in Young Children With Chronic Rhinosinusitis

et al. 2023

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ImportanceIntranasal corticosteroids (INCs) remain the first-line treatment of chronic rhinosinusitis (CRS) in both adults and children, despite the lack of evidence regarding their efficacy in the pediatric population. Similarly, their effect on the sinonasal microbiome has not been well documented.ObjectiveTo assess the clinical, immunological, and microbiological effects of 12 weeks of an INC in young children with CRS.Design, Setting, and ParticipantsThis open-label randomized clinical trial was performed in a pediatric allergy outpatient clinic in 2017 and 2018. Children aged 4 to 8 years with CRS diagnosed by a specialist were included. Data were analyzed from January 2022 to June 2022.InterventionsPatients were randomized to receive intranasal mometasone in an atomizer for 12 weeks (1 application per nostril, once per day) and supplemental 3-mL sodium chloride (NaCl), 0.9%, solution in a nasal nebulizer once a day for 12 weeks (INC group) or 3-mL NaCl, 0.9%, solution in a nasal nebulizer once a day for 12 weeks (control group).Main Outcomes and MeasuresMeasures taken both before and after treatment included the Sinus and Nasal Quality of Life Survey (SN-5), a nasopharynx swab for microbiome analysis by next-generation sequencing methods, and nasal mucosa sampling for occurrence of innate lymphoid cells (ILCs).ResultsOf the 66 children enrolled, 63 completed the study. The mean (SD) age of the cohort was 6.1 (1.3) years; 38 participants (60.3%) were male and 25 (39.7%) were female. The clinical improvement reflected by reduction in SN-5 score was significantly higher in the INC group compared with the control group (INC group score before and after treatment, 3.6 and 3.1, respectively; control group score before and after treatment, 3.4 and 3.8, respectively; mean between-group difference, −0.58; 95% CI, −1.31 to −0.19; P = .009). The INC group had a greater increase in nasopharyngeal microbiome richness and larger decrease in nasal ILC3 abundance compared with the control group. A significant interaction was observed between change in microbiome richness and the INC intervention on the prediction of significant clinical improvement (odds ratio, 1.09; 95% CI, 1.01-1.19; P = .03).Conclusions and RelevanceThis randomized clinical trial demonstrated that treatment with an INC improved the quality of life of children with CRS and had a significant effect on increasing sinonasal biodiversity. Although further investigation is needed of the long-term efficacy and safety of INCs, these data may reinforce the recommendation of using INCs as a first-line treatment of CRS in children.Trial RegistrationClinicalTrials.gov Identifier: NCT03011632

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“…43 Variations in the microbiome have been associated with differences in symptom severity and are predictive of surgical outcomes. 44 Furthermore, one retrospective analysis of sinonasal cultures taken during ESS found that males had a higher rate of Staphylococcus and anaerobes. 45 More research is needed to better understand the role of the microbiome in CRS pathogenesis, how the microbiome differs by gender, and its relationship with outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Gender on Long‐Term Quality of Life After Sinus Surgery for Chronic Rhinosinusitis

Vickery

Scangas

et al. 2023

The Laryngoscope

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ObjectiveTo identify the impact of gender on the clinical outcomes of endoscopic sinus surgery (ESS) through the comparison of quality of life measures in female and male patients who undergo surgical treatment for chronic rhinosinusitis (CRS).Study DesignProspective observational cohort study.MethodsPatients with CRS completed the 22‐item Sino‐Nasal Outcome Test (SNOT‐22) and EuroQol 5‐Dimension Survey (EQ‐5D) preoperatively and annually for 5 years following ESS. Health utility values (HUV) were calculated from EQ‐5D scores. Comparisons of cohort characteristics were performed with chi‐square and t‐tests. A multivariable linear mixed effects model evaluated changes in SNOT‐22 and HUV over time by gender.ResultsAmong the 1268 patients (54% female) enrolled, 789 and 343 completed postoperative surveys at one and 5 years, respectively. Preoperatively, females experienced more severe symptoms: mean SNOT‐22 score (51.1 ± 20.9 female vs. 44.7 ± 20.0 male, p < 0.001) and HUV (0.80 ± 0.14 female vs. 0.84 ± 0.11 male, p < 0.001). These gender differences were resolved by year one postoperatively (SNOT‐22: p = 0.083; HUV: p = 0.465). Two years after surgery, however, females reported more severe symptoms (SNOT‐22: 25.6 ± 20.7 female vs. 21.5 ± 17.4 male, p = 0.005; HUV: 0.88 ± 0.12 female vs. 0.90 ± 0.11 male, p = 0.018), a difference that persisted at year five. These gender‐related differences remained after adjusting for age, race, ethnicity, nasal polyps, history of prior ESS, and smoking status (p < 0.001). Within‐subject improvement was comparable between genders (SNOT‐22: p = 0.869; HUV: p = 0.611).ConclusionFemales with CRS reported more severe symptoms both before and 5 years after surgery compared to their male counterparts. Understanding the mechanism behind these gender‐related differences is important for optimizing CRS treatment.Level of Evidence2 Laryngoscope, 2023

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Association of the sinonasal bacterial microbiome with clinical outcomes in chronic rhinosinusitis: a systematic review

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.

Cited by 12 publications

References 48 publications

Study on the Salivary Microbial Alteration of Men With Head and Neck Cancer and Its Relationship With Symptoms in Southwest China

Study on the Salivary Microbial Alteration of Men With Head and Neck Cancer and Its Relationship With Symptoms in Southwest China

Effect of an Intranasal Corticosteroid on Quality of Life and Local Microbiome in Young Children With Chronic Rhinosinusitis

The Impact of Gender on Long‐Term Quality of Life After Sinus Surgery for Chronic Rhinosinusitis

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