Differential Nasal Recolonization and Microbial Profiles in Chronic Rhinosinusitis With Nasal Polyps Patients After Endoscopic Sinus Surgery or Dupilumab Treatment: A Prospective Observational Study.

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-10-23 DOI:10.1111/coa.14246

Antonino Maniaci, Gaia Vertillo Aluisio, Stefania Stefani, Salvatore Cocuzza, Jerome Rene Lechien, Thomas Radulesco, Justin Michel, Maria Santagati, Ignazio La Mantia

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引用次数: 0

Abstract

Introduction: The role of microbial profiles in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) pathogenesis is increasingly recognised, with microbial imbalances perpetuating inflammation. We performed this study to associate the different nasal microbiological profile changes with the response to surgical or monoclonal treatment.

Methods: This prospective observational study evaluated changes in the nasal microbial profiles of 44 patients (22 dupilumab, 22 surgery) over 6 months. Clinical assessments were performed at baseline and follow-ups, including Sino-Nasal Outcome Test-22 (SNOT-22) scores and Sniffin Sticks-Identification (SS-I) olfactory testing. Microbial profiling of nasal swabs was carried out by microbial culture and subsequent molecular identification by Polymerase chain reaction (PCR) and sequencing.

Results: Baseline characteristics of 44 patients (22 dupilumab, 22 surgery) enrolled in this study were similar between groups. In the dupilumab group, Staphylococcus epidermidis prevalence rose from 37.03% to 59.25%, while Pseudomonas aeruginosa was eradicated. Moreover, dupilumab stabilised Staphylococcus aureus at 63.64%, while its prevalence increased in the surgery group (from 22.72% to 50%). When bacterial groups were associated with clinical scores, P. aeruginosa carriers had worse SNOT-22 (21.00 ± 1.41) and SS-I (5.50 ± 0.71) scores. Instead, S. epidermidis-colonised patients exhibited significantly lower mean SNOT-22 (15.39 ± 8.54) and greater SS-I scores (8.39 ± 3.77). The best outcomes were found in the subgroup of S. epidermidis carriers undergoing the dupilumab treatment.

Conclusion: The two treatments modulated the microbial profiles differently, and, most importantly, clinical responses might depend on the association between treatment and the dominant bacterial species colonising the nasal cavity. Further investigation into microbial-restorative strategies could enhance outcomes for better treatment of CRS.

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内窥镜鼻窦手术或杜比鲁单抗治疗后慢性鼻窦炎伴鼻息肉患者鼻腔再定植和微生物谱的差异：前瞻性观察研究

导言：微生物特征在慢性鼻炎伴鼻息肉（CRSwNP）发病机制中的作用日益得到认可，微生物失衡会导致炎症长期存在。我们进行了这项研究，旨在将不同的鼻腔微生物特征变化与手术或单克隆治疗的反应联系起来：这项前瞻性观察研究评估了 44 例患者（22 例使用杜匹单抗，22 例接受手术治疗）在 6 个月内鼻腔微生物谱的变化。在基线和随访期间进行了临床评估，包括Sino-Nasal Outcome Test-22（SNOT-22）评分和Sniffin Sticks-Identification (SS-I)嗅觉测试。对鼻拭子进行微生物培养，然后通过聚合酶链式反应（PCR）和测序进行分子鉴定：结果：参加本研究的 44 位患者（22 位接受双鲁单抗治疗，22 位接受手术治疗）的基线特征在各组之间相似。在杜匹鲁单抗组，表皮葡萄球菌的感染率从 37.03% 上升到 59.25%，而铜绿假单胞菌则被根除。此外，dupilumab 使金黄色葡萄球菌的感染率稳定在 63.64%，而手术组的感染率则有所上升（从 22.72% 升至 50%）。当细菌群与临床评分相关联时，铜绿葡萄球菌携带者的 SNOT-22（21.00 ± 1.41）和 SS-I（5.50 ± 0.71）评分较低。相反，表皮葡萄球菌感染患者的 SNOT-22 平均值（15.39 ± 8.54）和 SS-I 评分（8.39 ± 3.77）则明显较低。接受杜比单抗治疗的表皮葡萄球菌携带者亚组的疗效最好：结论：两种治疗方法对微生物谱的调节不同，最重要的是，临床反应可能取决于治疗方法与鼻腔定植的主要细菌种类之间的关联。对微生物恢复策略的进一步研究可提高CRS的治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.