title: Probiotic manipulation of the chronic rhinosinusitis microbiome.
abstract: BACKGROUND
  Staphylococcus aureus (SA) is a key pathogenic component of the chronic rhinosinusitis (CRS) microbiome and is associated with increased disease severity and poor postoperative outcomes. Probiotic treatments potentially offer a novel approach to the management of pathogenic bacteria in these recalcitrant patients through supporting a healthy community of commensal species. This study aims to investigate the probiotic properties of Staphylococcus epidermidis (SE) against SA in a mouse model of sinusitis.
  
  
  METHODS
  Twenty C57/BL6 mice received intranasal inoculations of phosphate buffered saline (PBS), SE, SA, or a combination of SE and SA (SE+SA) for 3 days. Following euthanasia, the mouse snouts were harvested and prepared for histological analysis. Counts of periodic acid-Schiff (PAS)-positive goblet cells were the primary outcome measure.
  
  
  RESULTS
  Goblet cell counts were significantly higher in both the SA and SE+SA groups compared to those receiving PBS or SE alone (p < 0.05). However, the SE+SA group demonstrated significantly lower goblet cell counts compared to the SA group (p < 0.05). Mice receiving SE alone did not show a significant difference to those receiving PBS (p > 0.05). The presence of SA postinoculation was confirmed by culture in both the SA and SE+SA groups.
  
  
  CONCLUSIONS
  This study confirms the probiotic potential of SE against SA in a mouse model of sinusitis. Although the interactions that occur between many probiotic species and pathogens are yet to be fully understood, studies such as this support further exploration of ecologically-based treatment paradigms for the management of CRS.
authors.affiliation: Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Edward John
authors.initials: EJ
authors.lastname: Cleland
authors.forename: Amanda
authors.initials: A
authors.lastname: Drilling
authors.forename: Ahmed
authors.initials: A
authors.lastname: Bassiouni
authors.forename: Craig
authors.initials: C
authors.lastname: James
authors.forename: Sarah
authors.initials: S
authors.lastname: Vreugde
authors.forename: Peter-John
authors.initials: PJ
authors.lastname: Wormald
mesh_terms: D000818:Animals; D002452:Cell Count; D002908:Chronic Disease; D020397:Goblet Cells / Q000473:pathology; D006965:Hyperplasia; D051379:Mice; D008810:Mice, Inbred C57BL; D064307:Microbiota; D019936:Probiotics / Q000627:therapeutic use*; D012220:Rhinitis / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D013211:Staphylococcus aureus; D013212:Staphylococcus epidermidis
keywords: CRS; Staphylococcus aureus; Staphylococcus epidermidis; chronic rhinosinusitis; microbiome; probiotics