Abstract
The role of bacteria in chronic rhinosinusitis (CRS) is still not well understood. Whole microbiome analysis adds new aspects to our current understanding that is mainly based on isolated bacteria. It is still unclear how the results of microbiome analysis and the classical culture based approaches interrelate. To address this, middle meatus swabs and tissue samples were obtained during sinus surgery in 5 patients with CRS with nasal polyps (CRSwNP), 5 patients with diffuse CRS without nasal polyps (CRSsNP), 5 patients with unilateral purulent maxillary CRS (upm CRS) and 3 patients with healthy sinus mucosa. Swabs were cultured, and associated bacteria were identified. Additionally, parts of each tissue sample also underwent culture approaches, and in parallel DNA was extracted for 16S rRNA gene amplicon-based microbiome analysis. From tissue samples 4.2 ± 1.2 distinct species per patient were cultured, from swabs 5.4 ± 1.6. The most frequently cultured species from the swabs were Propionibacterium acnes, Staphylococcus epidermidis, Corynebacterium spp. and Staphylococcus aureus. The 16S-RNA gene analysis revealed no clear differentiation of the bacterial community of healthy compared to CRS samples of unilateral purulent maxillary CRS and CRSwNP. However, the bacterial community of CRSsNP differed significantly from the healthy controls. In the CRSsNP samples Flavobacterium, Pseudomonas, Pedobacter, Porphyromonas, Stenotrophomonas, and Brevundimonas were significantly enriched compared to the healthy controls. Species isolated from culture did not generally correspond with the most abundant genera in microbiome analysis. Only Fusobacteria, Parvimonas, and Prevotella found in 2 unilateral purulent maxillary CRS samples by the cultivation dependent approach were also found in the cultivation independent approach in high abundance, suggesting a classic infectious pathogenesis of odontogenic origin in these two specific cases. Alterations of the bacterial community might be a more crucial factor for the development of CRSsNP compared to CRSwNP. Further studies are needed to investigate the relation between bacterial community characteristics and the development of CRSsNP.
Highlights
Chronic rhinosinusitis (CRS) is among the most prevalent of all chronic diseases and affects 5–15% of the general population in Europe and the USA
CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) are the two major clinical phenotypes that imply different therapeutic approaches with CRSwNP being more responsive to therapy with corticosteroids (Fokkens et al, 2012)
CRSwNP and CRSsNP are the two major clinical phenotypes that imply different therapeutic approaches with CRSwNP being more responsive to therapy with corticosteroids
Summary
Chronic rhinosinusitis (CRS) is among the most prevalent of all chronic diseases and affects 5–15% of the general population in Europe and the USA. According to the European Position Paper on Rhinosinusitis and Nasal Polyps 2012, CRS is diagnosed clinically when a patient suffers two or more symptoms out of nasal blockage, nasal discharge, loss of smell and facial pressure or pain for more than 3 months with an additional finding of endoscopic signs of inflammation in the region of the middle meatus (swelling, polyps, mucopurulent discharge) and/or mucosal alterations in the computed tomography scan. This complex of symptoms can originate from sinunasal mucosal inflammation as a result of various conditions. Current research mainly addresses the pathologic host response itself and the external factors with bacteria being the main focus (Hoggard et al, 2017)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
