Understanding the Role of Biofilms and Superantigens in Chronic Rhinosinusitis

Abstract

Purpose of review: This review explores recent discoveries in our understanding of how biofilms and superantigens contribute to the pathogenesis of chronic rhinosinusitis (CRS). It also examines clinical implications and novel treatment approaches for biofilm associated CRS. Recent findings: While the role of biofilms in CRS has been studied for 14 years, research interest has now turned toward elucidating new methods of biofilm detection, microbial diversity, and novel treatment approaches. Recent studies on biofilm superantigens aim to clarify the immunological mechanisms of upper airway inflammation, particularly the type-2 response seen in nasal polyposis. Summary: Biofilms are a topic of research interest for their role in the pathogenesis of chronic rhinosinusitis, particularly when they elute superantigens. New studies on this topic focus on the molecular and cellular mechanisms at play.

Bacterial Biofilm and its Role in the Pathogenesis of Disease

“…The presence of biofilm has been associated with worse pre-operative radiological scores and post-operative outcome, as well as higher risk of recurrence [163][164][165][166]. S. aureus biofilm in particular appears to be more pathogenic than other bacterial species, and this has been suggested to be due to a severe local inflammatory response to S. aureus superantigens [167].…”

Antibiofilm peptides: overcoming biofilm-related treatment failure

“…Bacterial biolms appear to be involved in various respiratory tract infections including various pulmonary infections, as well as upper respiratory tract infections such as chronic rhinosinusitis, adenoiditis, chronic and recurrent middle ear infection, and recurrent tonsilitis. 7,87,88 P. aeruginosa biolms infections are the leading cause of morbidity and mortality in cystic brosis (CF) patients. 7,89 Chronic rhinosinusitis leads to 4.1 million physician visits annually and is oen treated surgically.…”

Current Perspective on Nasal Delivery Systems for Chronic Rhinosinusitis

“…Multidrug-resistant bacteria and polymicrobial biofilms are still a major challenge [ 33 ]. Topical antibiotic agents are a research hotspot recently because they can provide higher concentrations of antibiotics locally and limited systemic absorption [ 34 ]. A previous study compared nebulized antibiotics to nebulized saline; although CRS symptoms were found to be improved, nebulized antibiotics failed to offer additional benefits when compared with saline [ 35 ].…”