The microbiota-metabolite-immune axis in the olfactory cleft microenvironment: mechanisms and therapeutic implications for dysbiosis-driven olfactory dysfunction in chronic rhinosinusitis
By
Jin-Xiang Zhu
Guan-Jiang Huang
July 7, 2026
Clinical Report: The Role of the Microbiota-Metabolite-Immune Interaction
Overview This review discusses the microbiota-metabolite-immune (MMI) axis in chronic rhinosinusitis (CRS) and its association with olfactory dysfunction.
Background Chronic rhinosinusitis is a prevalent condition affecting approximately 12% of adults and is the leading cause of olfactory dysfunction.
Data Highlights No specific numerical data or trial data presented in the article.
Key Findings Dysbiosis in the olfactory niche includes enrichment of Acinetobacter johnsonii and depletion of commensals. Altered metabolite profiles in CRS-OD are linked to disturbed purine metabolism and reduced indole-3-acetic acid levels. Staphylococcus aureus superantigens may promote Th2 polarization and disrupt olfactory neurogenesis. Microbiota-targeted therapeutics, such as xylitol irrigation and probiotics, are emerging as potential interventions. The MMI axis framework integrates microbial dysbiosis, metabolite changes, and immune remodeling in CRS-associated olfactory dysfunction. Clinical Implications Clinicians should consider the role of microbial and metabolic factors in managing patients with olfactory impairment.
Conclusion The MMI axis offers a novel perspective on the mechanisms underlying olfactory dysfunction in CRS.
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