Probiotic manipulation of the chronic rhinosinusitis microbiome

Authors

  • Edward John Cleland MBBS,

    1. Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia
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  • Amanda Drilling BBtech (Hons),

    1. Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia
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  • Ahmed Bassiouni MBBCh,

    1. Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia
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  • Craig James MBBS (Hons), FRCPA,

    1. Adelaide Pathology Partners, Adelaide, South Australia, Australia
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  • Sarah Vreugde MD, PhD,

    1. Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia
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  • Peter-John Wormald MD

    Corresponding author
    1. Department of Surgery–Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia
    • Correspondence to: Peter-John Wormald, MD, Department of Otorhinolaryngology, Head and Neck Surgery, The Queen Elizabeth Hospital, 28, Woodville Road, Woodville, SA 5011, Australia; e-mail: peterj.wormald@adelaide.edu.au

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  • Funding sources for the study: Garnett Passe and Rodney Williams Memorial Foundation.

  • Potential conflict of interest: P.J.W. receives royalties from Medtronic and is a consultant for Neilmed; however, the author states that these conflicts are not relevant to this work.

Abstract

Background

Staphylococcus aureus (SA) is a key pathogenic component of the chronic rhinosinusitis (CRS) microbiome and is associated with increased disease severity and poor postoperative outcomes. Probiotic treatments potentially offer a novel approach to the management of pathogenic bacteria in these recalcitrant patients through supporting a healthy community of commensal species. This study aims to investigate the probiotic properties of Staphylococcus epidermidis (SE) against SA in a mouse model of sinusitis.

Methods

Twenty C57/BL6 mice received intranasal inoculations of phosphate buffered saline (PBS), SE, SA, or a combination of SE and SA (SE+SA) for 3 days. Following euthanasia, the mouse snouts were harvested and prepared for histological analysis. Counts of periodic acid–Schiff (PAS)-positive goblet cells were the primary outcome measure.

Results

Goblet cell counts were significantly higher in both the SA and SE+SA groups compared to those receiving PBS or SE alone (p < 0.05). However, the SE+SA group demonstrated significantly lower goblet cell counts compared to the SA group (p < 0.05). Mice receiving SE alone did not show a significant difference to those receiving PBS (p > 0.05). The presence of SA postinoculation was confirmed by culture in both the SA and SE+SA groups.

Conclusion

This study confirms the probiotic potential of SE against SA in a mouse model of sinusitis. Although the interactions that occur between many probiotic species and pathogens are yet to be fully understood, studies such as this support further exploration of ecologically-based treatment paradigms for the management of CRS.

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