Funding sources for the study: National Institutes of Health (1R15DE021194-01) NIDCR/NIAID to CML, LBP, and APL; Translational Genomics Research Institute Sylvia Chase Postdoctoral Fellow Grant; Northern Arizona University Technology and Research Initiative Fund (TRIF) fund; Cowden Endowment in Microbiology.
Medical therapy reduces microbiota diversity and evenness in surgically recalcitrant chronic rhinosinusitis
Article first published online: 10 JUL 2013
© 2013 ARS-AAOA, LLC
International Forum of Allergy & Rhinology
Volume 3, Issue 10, pages 775–781, October 2013
How to Cite
How to Cite this Article: Medical therapy reduces microbiota diversity and evenness in surgically recalcitrant chronic rhinosinusitis. Int Forum Allergy Rhinol. 2013;3:775–781., , , et al.
Potential conflict of interest: None provided.
- Issue published online: 15 OCT 2013
- Article first published online: 10 JUL 2013
- Manuscript Accepted: 21 MAY 2013
- Manuscript Revised: 27 APR 2013
- Manuscript Received: 12 MAR 2013
- National Institutes of Health (1R15DE021194-01) NIDCR/NIAID
- Northern Arizona University Technology and Research Initiative Fund (TRIF) fund
- Cowden Endowment in Microbiology
- chronic rhinosinusitis;
- Sinusitis, eosinophilic rhinitis;
- nasal polyposis;
- maximum medical therapy;
- 16S rRNA gene
Chronic rhinosinusitis (CRS) is a highly prevalent and heterogeneous condition frequently treated with antibiotics and corticosteroid therapy. However, the effect of medical therapy on sinus microbiota remains unknown.
We enrolled CRS patients (n = 6) with patent maxillary antrostomies and active mucosal inflammation, who had not received antibiotics or corticosteroids in the previous 8 weeks. A pretreatment and posttreatment maxillary sinus swab was collected, from which DNA was extracted, pyrosequenced, and analyzed using a naïve Bayesian classifier and ecological analyses.
Four patients showed significant improvement in endoscopic appearance. The shifts in microbiota in response to therapy were highly individualized. There was no single common microbiota profile among patients with similar clinical outcomes, but overall there was significant decrease in microbiota diversity (t(5) = 2.05, p = 0.10) and evenness (t(5) = 2.28, p = 0.07) after treatment.
Our findings strongly correlate with earlier studies that examined the impact of antibiotics on human microbiota. We observed that posttreatment, patients frequently became colonized by taxa that are less susceptible to the prescribed antibiotics. Our findings highlight the challenge in seeking generalizable diagnostic and therapeutic options in CRS, particularly regarding microbiological response and outcomes.