Scientists are targeting the nasal microbiome to find new treatments for a disease 'long-neglected by research'
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At this point in its research, sinonasal microbial transfer (SMT) represents an exciting ‘new frontier’ in otolaryngology.
—Geoffrey B. Trenkle, MD, otolaryngologist
Nearly 10% of people are living with chronic rhinosinusitis (CRS), or chronic sinus infections.
From loss of smell and facial pain to ongoing fatigue and inflammation, this group of people has to deal with an issue that largely hasn’t had a solid treatment option. [] The condition, at a minimum, can last as long as 12 weeks. []
Nasal microbiome holds the key?
The root of CRS is not known. It may be genetic, triggered by a virus, or it could come down to allergies or exposure to pollutants. Also, nearly 25% of people with CRS have asthma. []
A recent article in New Scientist notes the disease has been "long-neglected by research," and that patients suffer silently, "unaware that they aren’t alone or even that the condition exists. Those who do get proper treatment seldom shake the disease completely, and some don’t respond at all.” []
Monoclonal antibodies have been used to treat CRS, but they don't work on every type of CRS, and they’re not a solid long-term solution. Even surgery doesn’t guarantee a long-lasting fix.
This is where sinonasal microbial transfer (SMT) comes in—sort of like a fecal transfer, but for your nose. The idea is that the nasal microbiome holds the key.
Related: Scientists use dental floss to deliver vaccines without needlesWhat do experts think?
Geoffrey B. Trenkle, MD, otolaryngologist and surgeon at the Los Angeles Center for Ear, Nose, Throat and Allergy, says SMT shows promise. “At this point in its research, it represents an exciting ‘new frontier’ in otolaryngology.”
He says he wouldn’t call SMT a breakthrough—just yet. “While the early results are encouraging, it is still too soon to label sinonasal microbial transfer a definitive ‘breakthrough option.’”
He adds that breakthroughs in medicine typically involve widely adopted, proven treatments that fundamentally change a disease's management. But that doesn’t mean SMT’s not making waves. “It is gaining momentum as a potential new therapeutic option,” he says.
The goal of transfer is to restore a healthy microbial balance in the sinus cavities, which is often disrupted in patients with chronic inflammation, Dr. Trenkle explains.
"While still in its early stages of research, initial pilot studies and case series have shown promising results,” he says.
Thus, the evidence to date suggests that patients treated with SMT might achieve significant symptom improvement and continued relief lasting for months, but long-term safety and efficacy, Dr. Trenkle says, is still up in the air.
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