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Biofilms in chronic rhinosinusitis.
Jeffrey D Suh1, Noam A Cohen, James N Palmer
1Division of Rhinology, Department of ORL:HNS, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Current Opinion in Otolaryngology & Head and Neck Surgery
|November 27, 2009
Summary
Bacterial biofilms may cause chronic rhinosinusitis (CRS), necessitating new treatments. Emerging therapies, including nonantimicrobials, show promise for biofilm-associated CRS, but require further study.
Area of Science:
- Otolaryngology
- Microbiology
- Infectious Diseases
Background:
- Chronic rhinosinusitis (CRS) affects 16% of the US population, causing significant morbidity and economic burden.
- The pathophysiology of CRS is not fully understood, but bacterial biofilms are a potential contributing factor.
- Biofilms confer bacterial resistance to conventional treatments, complicating CRS management.
Purpose of the Study:
- To review the role of bacterial biofilms in chronic rhinosinusitis.
- To discuss emerging treatment strategies for biofilm-associated CRS.
- To explore novel therapies targeting biofilm formation and sinonasal inflammation.
Main Methods:
- Literature review of studies on bacterial biofilms in CRS.
- Analysis of emerging therapeutic agents including topical antimicrobials, surfactants, diuretics, and macrolides.
- Discussion of potential nonantimicrobial strategies and the importance of reducing sinonasal inflammation.
Main Results:
- Topical antimicrobials, surfactants, loop diuretics, and macrolide antibiotics show potential as adjuvant therapies for biofilm-associated CRS.
- Preliminary laboratory and small patient studies indicate promise for these novel treatments.
- Further clinical evaluation is necessary to confirm the efficacy and safety of these adjuvant therapies.
Conclusions:
- Bacterial biofilms are structured communities of bacteria within a protective matrix, potentially driving CRS.
- If biofilms are implicated in CRS, current treatment paradigms must evolve.
- Novel therapies, including nonantimicrobials, and strategies to reduce inflammation and protect cilia may be key to preventing and treating biofilm formation in CRS.
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