Local Pathogenic Bacteria in Allergic Rhinitis: A Novel Concept of Its Pathogenesis

Abstract

Background: It is still unclear to what extent microorganisms are involved in the pathogenesis of allergic rhinitis. Objective: Therefore, we examined the mucosal colonization with potential pathogenic bacteria (PPB) of the nasal cavity in allergic and nonallergic subjects. Methods: In an open prospective study of 389 office workers (297 men, mean age 42.5 years, and 92 women, mean age 36.7 years), bacterial swabs were taken selectively from both nasal cavities. Standard skin tests for various aeroallergens and negative control tests were conducted in parallel in these subjects. Results: In the 389 subjects, we found positive skin tests in 58 (15%); 37 of these revealed a high level of sensitivity, whilst the other 21 persons had low to moderate levels. Ninety percent of the 58 sensitive persons had PPB in their nasal cavity while only 36% (119) of the remaining 331 subjects with negative skin tests were shown to have PPB in nasal cultures (p < 0.001). Sixty-four percent of the sensitized subjects with PPB were found to have more than 2 PPB species and a positive correlation with the intensity of the skin reaction. In contrast, only 18% (22) of the 119 nonallergic test persons with PPB had more than 1 PPB species. Conclusions: This finding of an unusually high frequency of nasal PPB in subjects with positive skin tests to aeroallergens may indicate an involvement of PPB in the pathogenesis of allergic rhinitis. Yet, further data are still lacking to support this novel concept.

Nasal Symptoms Reduction and Decreased Neutrophilia in Japanese Cedar Pollinosis With Prophylactic Treatment With a Combination of Montelukast, Fexofenadine, and Fluticasone Nasal Spray

“…3 The association between bacterial colonization and seasonal allergic rhinitis has been identified in countries other than Japan. 26,27 Taken together, these studies lead us to postulate that bacterial activation induced neutrophilia, with associated nasal epithelial damage and hyperresponsiveness. This was supported by other reports of the involvement of bacteria and neutrophilia in the respiratory epithelium damage.…”

Involvement of Staphylococcus aureus and Moraxella catarrhalis in Japanese Cedar Pollinosis

“…Two publications identified bacterial colonization and seasonal allergic rhinitis in countries other than Japan. 33,34 However, they did not specifically postulate that bacterial activity led to nasal epithelial damage. Our results highlighted the potential importance of bacterial colonization in symptomatology of allergic rhinitis, and we postulated that epithelial damage may be a critical element.…”

Clinical Associations of Bitter Taste Perception and Bitter Taste Receptor Variants and the Potential for Personalized Healthcare

“…Moreover, T2R38 may also be naturally triggered in allergic rhinitis patients due to their altered and potentially more pathogenic bacterial microbiome in the nasal passage. [132][133][134] Since the prognosis of gram-negative bacteria-infected patients can also differ based on TAS2R38 variation, adopting early aggressive treatment regimens for patients with the AVI diplotype can be contemplated. For example, in CRS patients, the non-taster phenotype and AVI diplotype are associated with increased disease severity, more frequent sinus infections, lower quality of life, higher likelihood of undergoing surgical invention, higher CT scores of the paranasal sinuses, higher likelihood of cultural bacteria in nasal swab samples, higher likelihood of in vivo biofilm formation, more frequent respiratory exacerbations, and higher likelihood of having nasal polyposis.…”