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The nasopharyngeal microbiome is a complex ecosystem of bacteria, viruses, and fungi that resides in the human nasopharynx, acting as a critical interface between the external environment and the respiratory system [2, 3]. It serves significant biological functions, including the education of the mucosal immune system and the provision of colonization resistance against opportunistic pathogens such as Streptococcus pneumoniae and Haemophilus influenzae [1, 5]. Healthy microbial community states are typically characterized by a high diversity or dominance of beneficial commensals like Dolosigranulum pigrum and Corynebacterium species, which help maintain airway homeostasis by inhibiting pathogen overgrowth through metabolic and competitive mechanisms [1, 7]. Conversely, dysbiosis—an imbalance in these microbial populations—is strongly implicated in the pathogenesis of various respiratory diseases, including acute otitis media, pneumonia, and chronic conditions like asthma [4, 9]. Research also indicates that the composition of the nasopharyngeal microbiome can influence the clinical severity of viral infections, such as influenza and COVID-19, and serves as a potential risk screening tool for nasopharyngeal carcinoma [11, 15]. Therapeutic strategies currently focus on modulating this microbiome through the use of targeted antibiotics, probiotics, and vaccines to restore healthy community state types and prevent disease progression [2, 8].
The microbiome is modulated via the suppression of opportunistic pathobionts through antibiotics or vaccines, the introduction of protective commensal strains (probiotics) to restore ecological balance, and the competitive exclusion of pathogens through the production of antimicrobial metabolites like free fatty acids [1, 5, 8].
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