Bacterial analysis of the nasal microbiome is predictive of recurrence of nasal polyps in patients with chronic rhinosinusitis with more than 90% accuracy, according to a single center study from China.¹

In the prospective observational study published in the journal Allergy, researchers collected nasal swab samples from 85 patients with chronic rhinosinusitis with nasal polyps (CRSwNP), aged 18-73 years. The purpose of the study was to investigate if the nasal microbiome could predict recurrence of nasal polyps, which was also the primary outcome measure.

These patients had undergone endoscopic sinus surgery between August 2014 and March 2016 and were followed up postoperatively for 5 years. Patients treated with corticosteroids (topical or systemic)/antibiotics/immunomodulatory drugs 4 weeks preoperatively, those with unilateral rhinosinusitis, allergic fungal rhinosinusitis, antrochoanal polyps, immotile ciliary disease were excluded from the study. All nasal samples were subjected to 16S ribosomal RNA sequencing and bacteria analysis.

Polyp recurrence was noted in 39 patients, while 46 patients did not have polyp recurrence. The composition of the nasal microbiome was found to be different between the two groups of patients. Campylobacter, Bdellovibrio and Aggregatibacter were present in large numbers in patients with polyp recurrence, whereas samples from patients with non-recurrence of polyps contained more of Actinobacillus, Gemella and Moraxella. 

To test the predictive role of nasal microbiome for future nasal polyp recurrence, a training set of 48 samples was used in the regression model. Validation of the model showed that the area under the curve was 0.914 suggesting a predictor role for the nasal microbiome with 91.4% accuracy.

Porphyromonas, Bacteroides, Moryella, Aggregatibacter, Butyrivibrio, Shewanella, Pseudoxanthomonas, Friedmanniella, Limnobacter, and Curvibacter were identified as the bacterial groups that differentiated between the two groups on regression analysis and their presence was predictive of recurrence of nasal polyps.

Reference

1. Zhao Y, et al. Predicting the recurrence of chronic rhinosinusitis with nasal polyps using nasal microbiota. Allergy. 2022 Feb;77(2):540-549.  doi: 10.1111/all.15168.