the Nasal Microbiome and Its Impact on Respiratory Health

A Comprehensive Review for Medical Professionals

The nasal cavity has emerged as a significant reservoir for opportunistic pathogens, which can lead to various respiratory conditions, including allergic rhinitis, chronic rhinosinusitis, asthma, pneumonia, and otitis media.

The Nasal Microbiome and Chronic Rhinosinusitis (CRS)

Definitive evidence of bacteria's CRS role is lacking. However, studies show sinus infections elicit inflammation, chronic changes, and symptoms. CRS patients display distinct bacterial, gene, and immune patterns, with nasal dysbiosis indicating potential CRS/polyp progression.

Corticosteroids, immunosuppressants

While effectively reducing inflammation and managing certain medical conditions, can significantly affect the nasal immune ecosystem. These medications suppress the immune system's response, which can lead to several adverse consequences in the nasal passages and surrounding tissues.

Increased Susceptibility

Immunosuppressive drugs weaken the immune system's ability to fight infections.

Impaired Healing & Tissue Damage

Corticosteroids can hinder the body's natural healing processes.

Altered Microbiome

The nasal immune ecosystem is home to diverse microorganisms that play a crucial role in maintaining health.

Systemic Side Effects

In addition to the local effects on the nasal immune ecosystem, immunosuppressants can also cause systemic side effects

Adverse Effects on the Infant Immune

Though antibiotics have saved lives, exposure in infancy may increase disease susceptibility later on by disrupting nasal microbiota balance and immature immunity, underscoring the need to educate communities on antibiotic effects.

Microbiota Dysbiosis

Immune Response Modulation

Impact on Host Defense

Adaptive Immunity

Microbiota Dysbiosis

Human microbiota comprises bacteria, fungi, and viruses.

Impact on Host Defense Against Infection

Antibiotics cause microbial dysbiosis in infancy, leading to higher risk of diseases later.

• Antibiotics influence innate immune cells like dendritic cells, NK cells, and ILCs.

Antibiotics influence innate immune cells like dendritic cells, NK cells, and ILCs.

• Adaptive Immunity

Antibiotics impair humoral responses crucial for vaccine immunity.

Future Directions

Antibiotics are essential but have consequences in infants.

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