title: Rhinosinusitis and asthma-microbiome and new perspectives.
abstract: OBJECTIVE
  Microbiome is one of the new perspectives in human health research, including airway diseases. There are several publications about the relationship of the microbiome and allergic diseases. Although pathogenesis of chronic rhinosinusitis (CRS) as well as its relationship with asthma has been widely investigated, the relationship of the microbiome and CRS is not yet well known.
  
  
  RESULTS
  The relationship between the hygiene hypothesis and microorganisms inside the human body and in the environment around it has been clearly shown. Furthermore, several researchers have reported that the microorganisms in the gut play a major role in regulating the immune cells that are of relevance to asthma and allergic diseases, such as Th1, Th2, Th17, Treg and dendritic cells as well as Toll-like receptors. Reduced contact of people with natural environmental features and biodiversity may adversely affect the human commensal microbiota and its immunomodulatory capacity.Some studies have shown a close relationship between CRS and Staphylococcus aureus, anaerobes and so on in the nasal cavity or paranasal sinuses, although the relationship between CRS and microorganisms in the gut has not been demonstrated.
  
  
  CONCLUSIONS
  In this review, we summarized about the microbiome, mainly in asthma and allergic diseases. The relationship between asthma and CRS has been clearly shown, and in particular, CRS with nasal polyps (CRSwNP) has been considered to be Th2-dominant. Studies examining environmental microbial exposure in populations at risk for CRS are necessary to improve our understanding of the role this factor plays in disease development.
authors.affiliation: Department of Otorhinolaryngology, Showa University School of Medicine, Tokyo, Japan. h-suzaki@med.showa-u.ac.jp
authors.forename: Harumi
authors.initials: H
authors.lastname: Suzaki
authors.forename: So
authors.initials: S
authors.lastname: Watanabe
authors.forename: Ruby
authors.initials: R
authors.lastname: Pawankar
mesh_terms: D000818:Animals; D001249:Asthma / Q000209:etiology / Q000382:microbiology*; D002908:Chronic Disease; D006801:Humans; D061148:Hygiene Hypothesis; D007422:Intestines / Q000382:microbiology; D054892:Metagenome; D012220:Rhinitis / Q000209:etiology / Q000382:microbiology*; D012852:Sinusitis / Q000209:etiology / Q000382:microbiology*