Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Flinders University, Adelaide, Australia.
Laryngoscope. 2011 May;121(5):1085-91. doi: 10.1002/lary.21438.
Chronic rhinosinusitis is a common disease whose underlying aetiopathogenesis has not been completely understood. Amongst a range of other potential environmental triggers in this disease, a role has recently been proposed for bacterial biofilms. Adopting the biofilm paradigm to explain the initiation and maintenance of this disease may help to clarify previous inconsistencies in this disease that have resulted in the role of bacteria being questioned. Of particular interest is the association of bacterial biofilms with recalcitrant disease states. Over the last five years, research has progressed rapidly since biofilms were first identified on the surface of diseased sinonasal mucosa. Their presence there has now been associated with more severe disease that is often recalcitrant to current management paradigms. Technological advances are allowing accurate characterization of the bacterial and fungal species within these biofilms, which would appear to be an important step in improving our understanding of how these bacterial communities might interact with the host to cause disease. This is an unanswered, yet highly important, question in this field of research that will undoubtedly be an area of investigation in the near future. As the body of evidence suggesting biofilms may be involved in this disease grows, research interest has switched to the development of antibiofilm therapies. Given the unique properties of bacteria existing in this form, biofilm eradication strategies will need to incorporate novel medical therapies into established surgical practices as we attempt to improve the outcomes of our most difficult patients.
慢性鼻-鼻窦炎是一种常见疾病，其潜在的发病机制尚未完全了解。在这种疾病的一系列其他潜在环境诱因中，细菌生物膜最近被认为起了一定作用。采用生物膜范例来解释这种疾病的起始和维持，可能有助于澄清以前由于细菌作用受到质疑而导致的不一致之处。特别引人关注的是细菌生物膜与难治性疾病状态的关联。在过去的五年中，自从首次在病变的鼻腔鼻窦黏膜表面发现生物膜以来，研究进展迅速。现在已经发现它们的存在与更严重的疾病有关，而这些疾病往往对当前的治疗模式具有抗药性。技术进步使我们能够准确地描述这些生物膜中的细菌和真菌种类，这似乎是提高我们对这些细菌群落如何与宿主相互作用导致疾病的理解的重要一步。这是该研究领域中一个尚未解答但非常重要的问题，无疑将成为近期研究的一个领域。随着越来越多的证据表明生物膜可能与这种疾病有关，研究兴趣已经转向开发抗生物膜疗法。鉴于以这种形式存在的细菌具有独特的特性，因此在尝试改善我们最困难的患者的治疗效果时，生物膜清除策略将需要将新的医疗疗法纳入既定的手术实践中。
