The microbiota-metabolite-immune axis in the olfactory cleft microenvironment: mechanisms and therapeutic implications for dysbiosis-driven olfactory dysfunction in chronic rhinosinusitis - Scorecard - MDSpire

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

  • 0 min

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Clinical Scorecard: The Role of the Microbiota-Metabolite-Immune Interaction in the Olfactory Cleft: Insights and Therapeutic Considerations for Olfactory Dysfunction Associated with Dysbiosis in Chronic Rhinosinusitis

At a Glance

CategoryDetail
ConditionChronic Rhinosinusitis (CRS) with Olfactory Dysfunction (OD)
Key MechanismsMicrobiota-metabolite-immune (MMI) axis linking microbial dysbiosis, metabolite perturbation, and immune remodeling.
Target PopulationAdults with chronic rhinosinusitis, particularly young and middle-aged individuals.
Care SettingClinical settings focusing on chronic rhinosinusitis and olfactory dysfunction.

Key Highlights

  • CRS is the leading cause of olfactory dysfunction in adults, affecting 60% to 83% of patients.
  • 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 uric acid accumulation.
  • Staphylococcus aureus superantigens may promote T helper 2 polarization and disrupt olfactory neurogenesis.
  • Emerging therapies include xylitol irrigation, probiotics, and IL-4Rα blockade.

Guideline-Based Recommendations

Diagnosis

  • Assess olfactory function in patients with chronic rhinosinusitis.

Management

  • Consider microbiota-targeted therapeutics for olfactory dysfunction.

Monitoring & Follow-up

  • Monitor changes in olfactory function and microbial composition.

Risks

  • Persistent olfactory dysfunction may occur despite surgical interventions.

Patient & Prescribing Data

Adults with chronic rhinosinusitis experiencing olfactory dysfunction.

Therapeutic strategies targeting the microbiota and metabolites may restore olfactory homeostasis.

Clinical Best Practices

  • Integrate multi-omics data to understand the pathobiology of CRS-OD.
  • Differentiate olfactory cleft-specific evidence from broader sinonasal data.

Related Resources & Content

    Original Source(s)

    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

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