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Microbiome and disease in the upper airway

Lee, Jivianne T.a; Kim, Christine M.a; Ramakrishnan, Vijayb

Current Opinion in Allergy and Clinical Immunology: February 2019 - Volume 19 - Issue 1 - p 1–6
doi: 10.1097/ACI.0000000000000495
RHINITIS, SINUSITIS AND UPPER AIRWAY DISEASE: Edited by Ruby Pawankar and David P. Skoner

Purpose of review Microbiome refers to the genetic potential of resident microorganisms that inhabit a given niche. The exact role of the microbiome and its relation to chronic disease processes remains largely unknown, although various associations have been observed. We reviewed current literature investigating the microbiome of the upper airway by subsite (nasal cavity, sinus cavities, nasopharynx, and larynx) and its relation to chronic inflammatory disease processes.

Recent findings The disruption of indigenous microbiota at a specific subsite may lead to pathogen overgrowth and increased susceptibility to infection. This has previously been demonstrated in the gastrointestinal tract and lower airways. The role of the microbiome and its relation to pathogenesis of disease in the upper airway, however, is less clearly understood. The present review discusses the recent studies that appear to link dysbiosis to upper airway chronic inflammatory diseases.

Summary Despite mounting research, the role of microbiota in the upper airway remains poorly understood. Based on review of the current literature comparing healthy versus diseased patients with site-specific inflammatory conditions, a complex consortium of microbial communities inhabits the upper airway. Fluctuations in the baseline microbiome may contribute to disease pathogenesis, and improved understanding of the dynamics between shifting microbiota may be critical to guiding future medical therapy.

aDavid Geffen School of Medicine, Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles

bDepartment of Head and Neck Surgery, University of Colorado Medical Center, Denver, California, USA

Correspondence to Jivianne T. Lee, MD, David Geffen School of Medicine at UCLA, Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles 10833 Le Conte Ave., CHS 62-132, Los Angeles, CA 90095-1624, USA. E-mail:

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