Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colo.
Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colo.
J Allergy Clin Immunol. 2015 Aug;136(2):334-42.e1. doi: 10.1016/j.jaci.2015.02.008. Epub 2015 Mar 26.
Chronic rhinosinusitis (CRS) is a prevalent multifactorial disease process in which bacteria are believed to play a role in the propagation of inflammation. Multiple subtypes of CRS have been described based on clinical and pathologic features, but a detailed examination of the sinus microbiota in patients with CRS and its clinical subtypes has yet to be performed.
We sought to examine the resident microbiota of CRS subtypes and determine whether bacterial diversity is a predictor of disease outcomes.
Sinus swabs from patients with CRS and healthy subjects collected during endoscopic sinus surgery were analyzed by means of molecular phylogenetic analysis of 16S rDNA pyrosequences.
Fifty-six patients with CRS and 26 control subjects were studied. Biodiversity was similar between the CRS and control groups. Among the CRS subtypes examined, only 2 conditions (presence of purulence and comorbid condition of asthma) were associated with significant alterations in microbial community composition. In 27 patients with CRS who were followed postoperatively, those with better outcomes had more diverse bacterial communities present at the time of surgery, along with higher relative abundances of Actinobacteria.
Analysis of microbiota in a large cohort reveals that particular CRS phenotypes (asthma and purulence) are characterized by distinct compositions of resident bacterial communities. We found that bacterial diversity and composition are predictors of surgical outcome, promoting the concept of community ecology in patients with CRS.
慢性鼻-鼻窦炎（CRS）是一种普遍的多因素疾病过程，其中细菌被认为在炎症的传播中起作用。根据临床和病理特征，已经描述了多种 CRS 亚型，但尚未对 CRS 患者及其临床亚型的鼻窦微生物群进行详细检查。
我们试图研究 CRS 亚型的常驻微生物群，并确定细菌多样性是否是疾病结果的预测因子。
通过 16S rDNA 焦磷酸测序的分子系统发育分析，对接受内镜鼻窦手术的 CRS 患者和健康受试者的鼻窦拭子进行分析。
研究了 56 例 CRS 患者和 26 例对照受试者。CRS 组和对照组之间的生物多样性相似。在所检查的 CRS 亚型中，只有 2 种情况（存在脓性分泌物和哮喘合并症）与微生物群落组成的显著改变相关。在 27 例接受术后随访的 CRS 患者中，手术时具有更多样化细菌群落的患者具有更好的结果，同时放线菌的相对丰度更高。
对大样本量的微生物组进行分析表明，特定的 CRS 表型（哮喘和脓性分泌物）的特征是常驻细菌群落的组成不同。我们发现细菌多样性和组成是手术结果的预测因子，这促进了 CRS 患者的群落生态学概念。
