The sinonasal bacterial microbiome in health and disease

Ramakrishnan, Vijay R.; Hauser, Leah J.; Frank, Daniel N.

doi:10.1097/moo.0000000000000221

Cited by 58 publications

(63 citation statements)

References 46 publications

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“…Within the sinuses, a similar mucosal bacterial burden is present regardless of the presence or severity of sinus disease, suggesting a confluent bacterial community may saturate mucosal surfaces in both diseased and healthy sinuses . Although mucosal bacteria are similar in number across disease states, community composition varies greatly …”

Section: Discussionmentioning

confidence: 99%

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Loss of Microbial Niche Specificity Between the Upper and Lower Airways in Patients With Cystic Fibrosis

2018

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Objectives/Hypothesis To determine the relationship between mucosal‐associated sinus and bronchial microbiota in cystic fibrosis (CF) patients compared to non‐CF patients with chronic rhinosinusitis (CRS). Study Design Case series. Methods We examined the microbial composition of 52 paired sinus and bronchial brushings from 26 patients with CRS. Paired airway samples from nine subjects with CF were compared with samples from 17 non–CF‐CRS disease control patients. The Illumina MiSeq platform was used to sequence the V4 region of the 16S rRNA gene. Sequences were analyzed using QIIME 1.9.0. Results CF patients demonstrate increased severity of sinus inflammation (Lund‐Mackay score 16.3 vs. 12.4, P = .023) and diminished diversity of microbial communities in both the sinuses (Shannon diversity 0.98 vs. 3.3, P = .009) and lungs (Shannon diversity 2.2 vs. 4.0, P = .042) relative to non–CF‐CRS. Non–CF‐CRS sinus and lung microbiota were distinct and clustered by niche (sinus vs. lung, P = .004). However, CF airway microbiota demonstrated a loss of niche specificity (sinus vs. lung, P = .492). Two CF patients underwent lung transplantation at 4.5 and 9 months prior to sampling. Sinus and lung samples from these two patients demonstrated distinct microbial communities. Conclusions Patients with CF undergoing surgery for CRS exhibit substantial bacterial community collapse in the sinuses and a loss of niche specificity between the upper and lower airways compared to non‐CF patients with CRS. These results extend previous studies elucidating the lower airway microbiome in cystic fibrosis and provide support for the concept of microbial translocation in the cystic fibrosis airways. Level of Evidence 4 Laryngoscope, 129:544–550, 2019

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Section: Discussionmentioning

confidence: 99%

“…7 Although mucosal bacteria are similar in number across disease states, community composition varies greatly. [5][6][7]36 There is a growing body of literature identifying the importance of sinus microbes in the pathogenesis of CF pulmonary disease. Culture studies have demonstrated concordance between sinus and pulmonary pathogens.…”

Section: Discussionmentioning

confidence: 99%

Loss of Microbial Niche Specificity Between the Upper and Lower Airways in Patients With Cystic Fibrosis

2018

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“…A major implication of the current study is the potential moving forward for a single-site sampling method, an identified need to facilitate future longitudinal studies [50]. At this point, analyses of sinus microbiota have been challenging and difficult to replicate due to concerns about inclusion of control subjects, optimal sampling technique, sampling site, laboratory protocols, and data analysis pipelines [51].…”

Section: Discussionmentioning

confidence: 99%

Investigation of sinonasal microbiome spatial organization in chronic rhinosinusitis

Ramakrishnan

Gitomer

Kofonow

et al. 2016

Int Forum Allergy Rhinol

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Background Chronic rhinosinusitis (CRS) is a multifactorial inflammatory airway disorder in which bacteria are implicated in the initiation and/or sustenance of disease in some patients. The sinuses are colonized by bacteria even in health, and the potential for sinus-specific niches harboring unique microbial consortia raises questions for clinical and research investigation. Objective To determine the degree to which resident upper airways microbiota differ between individuals and anatomic sites, in order to determine the optimal site of microbial sampling for study in CRS. Methods 8 CRS patients undergoing primary surgery were sampled bilaterally at the anterior nares, middle meatus, nasopharynx, maxillary, frontal, and sphenoid sinuses, for investigation using broad-range bacterial 16S rRNA sequencing. Results Between-subject variability in bacterial microbiota was substantially greater than within-subject variability. The middle meatus was fairly representative of the underlying sinuses, although corynebacteria were detected at higher abundances in the middle meatus, relative to the maxillary (P<0.1), frontal (P<0.05), or sphenoid (P<0.1) sinuses. Conclusion Interpersonal variation of the upper airway microbiome greatly outweighs niche-specific differences. The middle meatus is a fair representation of the underlying sinuses and may be considered for use as a simple single site for sampling in longitudinal studies or in subjects who have not undergone sinus surgery.

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“…Nevertheless, these few studies claim that CRS patients can have a reduced diversity, altered nasal microbiota, an increase in S. aureus or Corynebacterium tuberculostearicum abundance, and greater densities of bacterial and/or fungal cells. However, the role of bacteria in the pathogenesis of CRS has yet to be established with certainty, as recent reviews argue that there is still no consensus on the most common bacteria present in the healthy or diseased state, and there is no clear causative or protective single organism (Mahdavinia et al, 2016;Ramakrishnan et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Exploring the bacterial assemblages along the human nasal passage

Wos‐Oxley

Chaves‐Moreno

Jáuregui

et al. 2016

Environmental Microbiology

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The human nasal passage, from the anterior nares through the nasal vestibule to the nasal cavities, is an important habitat for opportunistic pathogens and commensals alike. This work sampled four different anatomical regions within the human nasal passage across a large cohort of individuals (n = 79) comprising individuals suffering from chronic nasal inflammation clinically known as chronic rhinosinusitis (CRS) and individuals not suffering from inflammation (CRS-free). While individuals had their own unique bacterial fingerprint that was consistent across the anatomical regions, these bacterial fingerprints formed into distinct delineated groups comprising core bacterial members, which were consistent across all four swabbed anatomical regions irrespective of health status. The most significant observed pattern was the difference between the global bacterial profiles of swabbed and tissue biopsy samples from the same individuals, being also consistent across different anatomical regions. Importantly, no statistically significant differences could be observed concerning the global bacterial communities, any of the bacterial species or the range of diversity indices used to compare between CRS and CRS-free individuals, and between two CRS phenotypes (without nasal polyps and with nasal polyps). Thus, the role of bacteria in the pathogenesis of sinusitis remains uncertain.

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The sinonasal bacterial microbiome in health and disease

Cited by 58 publications

References 46 publications

Loss of Microbial Niche Specificity Between the Upper and Lower Airways in Patients With Cystic Fibrosis

Loss of Microbial Niche Specificity Between the Upper and Lower Airways in Patients With Cystic Fibrosis

Investigation of sinonasal microbiome spatial organization in chronic rhinosinusitis

Exploring the bacterial assemblages along the human nasal passage

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