Research Topic

Advances in Understanding the Pathogenesis of Chronic Rhinosinusitis

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About this Research Topic

Chronic rhinosinusitis (CRS) is a common and morbid condition that affects about 5% of the population in western societies. It is treated medically, with combinations of antibiotics and corticosteroids, but the condition is often recalcitrant and surgery is required. Even after sinus surgery, there is a ...

Chronic rhinosinusitis (CRS) is a common and morbid condition that affects about 5% of the population in western societies. It is treated medically, with combinations of antibiotics and corticosteroids, but the condition is often recalcitrant and surgery is required. Even after sinus surgery, there is a significant rate of recurrence.

Our understanding of the role of changes in the microbial biota in this condition were until recently based on cultivation studies, and these failed to find a consistent link between bacterial species and chronic rhinosinusitis. A subgroup of CRS patients are colonized by fungi to which they mount a local immune reaction (allergic fungal sinusitis).

Modern molecular techniques have enabled the whole sinonasal microbiome to be determined, leading to a fundamental change in the way that we now perceive the microbiology of the sinus mucosa. We now understand that bacteria can adopt different phenotypes depending on the physical conditions, and that intramucosal or intracellular growth of bacteria may be part of the reason for their recalcitrance.

Of note have been the many parallels drawn between the role of the microbiome in other inflammatory diseases, and its interaction with the mucosal immune system. Conditions such as bronchiectasis, inflammatory bowel disease, chronic cystitis and subacute bacterial endocarditis share features that we have observed in chronic rhinosinusitis. CRS research is facilitated by the relative ease with which specimens can be retrieved from patients.

In this Research Topic, we encourage the submission of original research reports, methods articles, perspectives, reviews and mini-reviews on the following topics:

the microbiology of CRS
the response of associated microorganisms to treatment
the mucosal inflammatory response


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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