Upper-airway dysbiosis related to frequent sweets consumption increases the risk of asthma in children with chronic rhinosinusitis

Paweł Majak; Katarzyna Molińska; Marta Latek; Błażej Rychlik; Marcin Wachulec; Andrzej Błauż; Aleksandra Budniok; Martyna Gruchała; Jakub Lach; Marta Sobalska-Kwapis; Monika Baranowska; Klaudyna Królikowska; Dominik Strapagiel; Joanna Majak; Dorota Czech; Cezary Pałczyński; Piotr Kuna

doi:10.1111/pai.13417

Upper-airway dysbiosis related to frequent sweets consumption increases the risk of asthma in children with chronic rhinosinusitis

Pediatr Allergy Immunol. 2021 Apr;32(3):489-500. doi: 10.1111/pai.13417. Epub 2020 Dec 18.

Authors

Paweł Majak¹, Katarzyna Molińska², Marta Latek², Błażej Rychlik³, Marcin Wachulec³, Andrzej Błauż³, Aleksandra Budniok³, Martyna Gruchała³, Jakub Lach⁴, Marta Sobalska-Kwapis⁴, Monika Baranowska⁴, Klaudyna Królikowska⁴, Dominik Strapagiel⁴, Joanna Majak⁵, Dorota Czech⁶, Cezary Pałczyński⁷, Piotr Kuna²

Affiliations

¹ Department of Pediatric Pulmonology, Medical University of Lodz, Lodz, Poland.
² Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland.
³ Department of Molecular Biophysics, University of Lodz, Lodz, Poland.
⁴ Biobank Lab, Department of Molecular Biophysics, University of Lodz, Lodz, Poland.
⁵ Audiology and Phoniatrics Clinic, Nofer Institute of Occupational Medicine, Lodz, Poland.
⁶ Department of Paediatric Otolaryngology, Audiology and Phoniatrics, Medical University of Lodz, Lodz, Poland.
⁷ Collegium Medicum, Jan Kochanowski University, Kilece, Poland.

PMID: 33222307
DOI: 10.1111/pai.13417

Abstract

Background: Innate immunity response to local dysbiosis seems to be one of the most important immunologic backgrounds of chronic rhinosinusitis (CRS) and concomitant asthma. We aimed to assess clinical determinants of upper-airway dysbiosis and its effect on nasal inflammatory profile and asthma risk in young children with CRS.

Methods: We recruited one hundred and thirty-three children, aged 4-8 years with doctor-diagnosed CRS with or without asthma. The following procedures were performed in all participants: face-to-face standardized Sinus and Nasal Quality of Life questionnaire, skin prick test, taste perception testing, nasopharynx swab, and sampling of the nasal mucosa. Upper-airway dysbiosis was defined separately by asthma-specific microbiome composition and reduced biodiversity. Multivariate methods were used to define the risk factors for asthma and upper-airway dysbiosis and their specific inflammatory profile of nasal mucosa.

Results: The asthma-specific upper-airway microbiome composition reflected by the decreased ratio of Patescibacteria/Actinobacteria independently of atopy increased the risk of asthma (OR:8.32; 95%CI: 2.93-23.6). This asthma-specific microbiome composition was associated with ≥ 7/week sweet consumption (OR:2.64; 95%C:1.11-6.28), reduced biodiversity (OR:3.83; 95%CI:1.65-8.87), the presence of Staphylococcus strains in the nasopharynx (OR:4.25; 95%CI:1.12-16.1), and lower expression of beta-defensin 2, IL-5, and IL-13 in the nasal mucosa. The reduced biodiversity was associated with frequent antibiotic use and with a higher nasal expression of IL-17 and T1R3 (sweet taste receptor). In asthmatic children, reduced sweet taste perception was observed.

Conclusions: Specific upper-airway dysbiosis related to frequent sweet consumption, frequent antibiotic courses, and altered nasal immune function increases the risk of asthma in young children with CRS.

Trial registration: ClinicalTrials.gov NCT03011632.

Keywords: asthma; chronic rhinosinusitis; innate immunity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Asthma* / epidemiology
Child
Child, Preschool
Chronic Disease
Dysbiosis
Humans
Nasal Polyps*
Quality of Life
Rhinitis* / epidemiology
Sinusitis* / epidemiology

Associated data

ClinicalTrials.gov/NCT03011632