The relationship of biofilms to chronic rhinosinusitis.
General otolaryngology
Current Opinion in Otolaryngology & Head & Neck Surgery. 16(3):237-241, June 2008. Hunsaker, Darrell H a; Leid, Jeff G b
Abstract: Purpose of review: To provide an update on the state of biofilm research in otolaryngology.
Recent findings: Chronic rhinosinusitis is a polymicrobial infection, which includes planktonic and biofilm infections with bacterial and fungal elements.
The importance of genetic shift in microbes, when converting into a biofilm state, as well as the multiple phenotypes in each bacterial colony cannot be overemphasized.
This creates a very sophisticated community of pathogens, some of which will likely survive a simple chemical treatment.
Sinus cultures cannot be expected to provide a complete knowledge of the cause of chronic sinusitis.
A new diagnostic method and innovative treatment plans will be necessary to provide a lasting treatment of chronic rhinosinusitis.
Surgery combined with postoperative treatment is the most effective mean of controlling the majority of chronic rhinosinusitis infections.
The challenges associated with the treatment of chronic rhinosinusitis patients may be met by focusing more on the community of microorganism present in the sinuses.
Summary: The understanding of the implication of chronic biofilm infections is growing rapidly but will require an enormous effort to completely control chronic rhinosinusitis.
(C) 2008 Lippincott Williams & Wilkins, Inc.
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Reduced Levels of Lactoferrin in Biofilm-Associated Chronic Rhinosinusitis.
Sinonasal
Laryngoscope. 118(5):895-901, May 2008. Psaltis, Alkis J. MBBS; Wormald, Peter-John MD; Ha, Kien R. MBBS; Tan, Lor Wai PhD
Abstract: Objective/Hypothesis: The diverse antipathogenic action of lactoferrin has been well characterized.
In addition, it is the human body's only known antimicrobial peptide with antibiofilm properties.
The purpose of this study was to examine the nasal mucosal expression of lactoferrin in the biofilm-mediated disease, chronic rhinosinusitis (CRS).
Study Design/Methods: Nasal biopsies from 41 CRS patients and 21 healthy controls were analyzed using confocal scanning laser microscopy (CSLM) and scanning electron microscopy (SEM) for the presence of biofilms.
The messenger ribonucleic acid (mRNA) and protein level of lactoferrin in this tissue were also determined by quantitative real-time reverse-transcriptase polymerase chain reaction (qRT-PCR) and enzyme linked immunosorbent assay (ELISA), respectively.
Results: Lactoferrin expression in chronic rhinosinusitis patients at both mRNA and protein level was downregulated relative to controls.
Biofilm-positive CRS patients showed a much greater reduction in lactoferrin expression than biofilm-negative patients; mRNA median fold change biofilm positive = 0.03 (interquartile range 0.005-0.15) and biofilm-negative CRS median fold change = 0.49 (interquartile range 0.15-0.81) with median lactoferrin protein expression biofilm-positive patients' median lactoferrin protein expression = 32.58 ng/mL (interquartile range 8.67-59.9 ng/mL) and biofilm-negative patients' median lactoferrin expression = 114.40 ng/mL (interquartile range 75.41-163.1 ng/mL).
Conclusions: Genetic, transcriptional, or translational deficiencies in lactoferrin synthesis may reduce the functional level of this important antimicrobial/antibiofilm peptide in the nasal secretions of CRS patients, predisposing certain individuals to bacterial colonization, biofilm development, and recalcitrant sinus disease.
(C) The American Laryngological, Rhinological & Otological Society, Inc.