2022 Fiscal Year Final Research Report

Gut microbiome Candida as a new pathophysiological causative factor of intractable eosinophilic chronic rhinosinusitis

Research Project

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Project/Area Number	19K09917
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 56050:Otorhinolaryngology-related
Research Institution	Nippon Medical School
Principal Investigator	MATSUNE Shoji 日本医科大学, 医学部, 教授 (00253899)
Co-Investigator(Kenkyū-buntansha)	大橋隆治日本医科大学, 医学部, 准教授 (00328783) 吾妻安良太日本医科大学, 医学部, 教授 (10184194) 大久保公裕日本医科大学, 大学院医学研究科, 大学院教授 (10213654) 若林あや子日本医科大学, 医学部, 講師 (30328851) 若山望日本医科大学, 大学院医学研究科, 非常勤講師 (90813238)
Project Period (FY)	2019-04-01 – 2023-03-31
Keywords	好酸球性鼻副鼻腔炎 / type 2炎症 / 腸内フローラ / カンジダ / 皮内テスト / 遅延型過敏反応
Outline of Final Research Achievements	Eosinophilic chronic rhinosinusitis (ECRS)is an intractable upper airway inflammatory disease that is often complicated with bronchial asthma. Type 2 inflammation consisted of innate immunity and helper T2 -mediated allergy has been regarded as the pathophysiology of ECRS. However, it remains unclear why only some individuals develop ECRS with type 2 inflammation when they inhale common air components that irritate the sinus mucosa. In our present study, we hypothesized that there is more Candida in the gut microbiome in patients with ECRS more often than in patients with NECRS. This hypothesis was assessed with stool samples from all patients with ECRS and NECRS before surgery. A Candida-selective CHROM CANDIDA Ⅱ agar medium system was used for this assessment. Candida in stool was statistically more common in patients with ECRS than in patients with NECRS. Dysbiosis of the gut microbiome, such as an increase in Candida, was concluded to be an important causative factor of ECRS.
Free Research Field	耳鼻咽喉科
Academic Significance and Societal Importance of the Research Achievements	腸内フローラにおけるカンジダの増加が、好酸球性鼻副鼻腔炎病態に関与している可能性がある。腸内フローラにおけるカンジダの増加が、難治性鼻府K鼻腔炎の副鼻腔粘膜局所での type 2 炎症の全身レベルでのpredisposing factorになっている可能性があり、本疾患の病態論に基づく、予防、診断、治療を大きく変える可能性がある。