Objective:

To investigate the association between oral microbiome richness and chronic rhinosinusitis (CRS) and other respiratory outcomes.

Approach:

• Study Design: Cross-sectional analysis of adults from the European Community Respiratory Health Survey across three centers.
• Participants: Gingival sampling performed on 355 participants, with metagenomic sequencing successful for 335 samples.
• Outcomes Measured: Respiratory outcomes included asthma, chronic rhinosinusitis, sensitization status, spirometry, and fractional exhaled nitric oxide.
• Data Analysis: Adjusted analyses were conducted to assess associations between oral microbiome richness and respiratory outcomes.

Key Findings:

• Increasing oral microbiome richness was associated with chronic rhinosinusitis overall, with the strongest association among participants with nonallergic chronic rhinosinusitis.
• No consistent association was observed between alpha diversity and asthma, forced expiratory volume in 1 second, or fractional exhaled nitric oxide.
• Functional gene profiling revealed broader differences, with many unique genes present in participants without asthma or chronic rhinosinusitis.

Interpretation:

Increased richness of the oral microbiome is associated with a higher prevalence of nonallergic chronic rhinosinusitis.

Limitations:

• Cross-sectional design limits conclusions about causality.
• Cohort was enriched for participants with respiratory symptoms, not representative of the general population.
• Recent antibiotic-use data were unavailable.
• Asthma and chronic rhinosinusitis were based on questionnaire responses, potentially leading to misclassification.

Conclusion:

The study found an association between oral microbiome richness and chronic rhinosinusitis, particularly nonallergic types, while no consistent association with asthma was found.

Sources:

• BMJ Open Respiratory Research