The effect of medical treatments on the bacterial microbiome in patients with chronic rhinosinusitis: a pilot study

Jain, Ravi; Hoggard, Michael; Zoing, Melissa; Jiang, Yannan; Biswas, Kristi; Taylor, Michael W.; Douglas, Richard

doi:10.1002/alr.22110

Cited by 24 publications

(30 citation statements)

References 53 publications

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“…found two Corynebacterium species to be more prevalent in control patients compared to CRS patients: Corynebacterium confusum (73% control vs 26% CRS, p = 0.023) and Corynebacterium fastidiosum (64% control vs 22% CRS, p = 0.026). Jain et al 27 . demonstrated Corynebacterium or Staphylococcus as the dominant species in all 26 study patients before treatment.…”

Section: Resultsmentioning

confidence: 95%

“…The included 2018 study by Jain et al 27 . compared stable CRS patients treated with doxycycline, prednisone, or no treatment.…”

Section: Resultsmentioning

confidence: 99%

“…There is substantial variation in the native microbiome between individuals, which is another limitation of analyzing the microbiome 33,42 . High interindividual variation has also been identified as a factor in CRS microbiome studies 27 . In addition, studies have reported that variability between sinuses within the single CRS patient is significantly less than variability across different patients 43,44 .…”

Section: Discussionmentioning

confidence: 99%

“…To have a clinically relevant bearing on patient care, any pathophysiologic mechanisms of disease would ideally translate to clinical outcomes. At present it is unclear how the sinonasal microbiome in CRS translates to clinical outcomes; eg, in relation to medical and surgical management of CRS 19,20,27 . In this systematic review, we seek to synthesize the current literature on the sinonasal microbiome in CRS and how it may affect clinical outcomes related to QOL.…”

mentioning

confidence: 99%

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

Wang

Moore

Epperson

et al. 2020

Int Forum Allergy Rhinol

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Section: Resultsmentioning

confidence: 95%

“…The included 2018 study by Jain et al 27 . compared stable CRS patients treated with doxycycline, prednisone, or no treatment.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

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

Wang

Moore

Epperson

et al. 2020

Int Forum Allergy Rhinol

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“…Jain et al . evaluate the effects of a short (7‐day) course of either doxycycline or prednisone on the sino‐nasal (sinonasal microbiome) bacterial microbiome in a randomized prospective trial.…”

mentioning

confidence: 99%

Additional options in chronic rhinosinusitis management

Kennedy¹

2018

Int Forum Allergy Rhinol

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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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The effect of medical treatments on the bacterial microbiome in patients with chronic rhinosinusitis: a pilot study

Abstract: The short-term response of bacterial communities to antibiotic or corticosteroid therapy is unpredictable. This study suggests that the use of systemic therapy in patients with stable CRS should be rationalized to minimize antibiotic-associated morbidity and bacterial dysbiosis.

Cited by 24 publications

References 53 publications

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

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

Additional options in chronic rhinosinusitis management

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

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