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Lactobacillus rhamnosus SP (often identified as the SP1 strain) is a live biotherapeutic bacterium being investigated for its potential to restore sinonasal microbiome health. In a clinical research context led by the **Royal Brisbane and Women's Hospital**, this strain is utilized as a component of a multi-strain probiotic nasal saline rinse designed for patients with **chronic rhinosinusitis (CRS)**. The formulation typically includes four Lactobacillus strains: *L. rhamnosus*, *L. plantarum*, *L. casei*, and *L. salivarius*. The therapeutic rationale is based on the observation that CRS patients often exhibit sinonasal dysbiosis, characterized by a loss of microbial diversity and overgrowth of pathogens like *Staphylococcus aureus*. By delivering high concentrations of beneficial Lactobacilli directly to the nasal cavity, the treatment aims to competitively inhibit pathogenic colonization, modulate local inflammatory responses, and promote the restoration of the mucosal barrier. A Phase 1 study has evaluated the safety and exploratory efficacy of this daily nasal rinse in adults with CRS who have previously undergone sinus surgery.
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