Microbial Metabolites as Crucial Modulators of Nasal Mucosal Immune Tolerance in Chronic Rhinosinusitis: Moving Beyond Dysbiosis

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Chronic rhinosinusitis (CRS) affects approximately 11% of adults globally and is characterized by persistent inflammation of the nasal cavity and sinuses.
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Microbial metabolites, rather than microbial identity, are emerging as key immunological mediators in the crosstalk between commensal microbiota and host.
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Short-chain fatty acids, tryptophan-derived indoles, and secondary bile acids are identified as protective metabolites that modulate immune responses in CRS.
4

Pathobiont-derived virulence factors, particularly from Staphylococcus aureus, disrupt nasal mucosal immune tolerance and contribute to CRS pathology.
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Postbiotic supplementation of purified bioactive metabolites is proposed as a precision therapeutic strategy to restore nasal mucosal immune homeostasis.

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