Beyond dysbiosis: microbial metabolites as key remodelers of nasal mucosal immune tolerance in chronic rhinosinusitis
By
Guan-Jiang Huang
Zi-Qing Chen
Chao-Qing Long
Qi-Ping Luo
Zhi-Jun Fan
Biao-Qing Lu
June 16, 2026
Clinical Scorecard: Microbial Metabolites as Crucial Modulators of Nasal Mucosal Immune Tolerance in Chronic Rhinosinusitis: Moving Beyond Dysbiosis
At a Glance
Category Detail
Condition Key Mechanisms Microbial metabolites are suggested to modulate immune responses through specific receptor signaling pathways. Target Population Care Setting
Key Highlights
CRS affects approximately 11% of adults globally. Microbial metabolites, rather than microbial identity, are key immunological mediators. Postbiotic supplementation is proposed as a therapeutic strategy, pending further evidence. CRSwNP is driven by type 2 inflammation, while CRSsNP exhibits type 1 or type 3 inflammation. Loss of nasal mucosal immune tolerance is a defining feature of CRS. Guideline-Based Recommendations
Diagnosis
CRS is diagnosed based on persistent symptomatic inflammation lasting at least 12 weeks. Management
Current management includes corticosteroids, functional endoscopic sinus surgery, and targeted biological therapies, as per clinical guidelines. Monitoring & Follow-up
Monitor for disease recurrence post-treatment. Risks
High recurrence rates of CRS despite treatment. Patient & Prescribing Data
Adults with chronic rhinosinusitis, including CRSwNP and CRSsNP.
Consider endotype-specific metabolite candidate selection guided by individual patient metabolomics profiling.
Clinical Best Practices
Focus on the metabolite-immune receptor axis for therapeutic strategies, as supported by current research. Evaluate the role of microbial metabolites in immune modulation, referencing specific studies. Related Resources & Content
