Staphylococcus aureus Orchestrates Type 2 Airway Diseases

Staphylococcus aureus persistently colonizes the nostrils of one-third of the population but colonizes the sinus mucosa in up to 90% of patients with nasal polyps, implying a possible role in airway disease. Recent findings give new mechanistic insights into the ability of S. aureus to trigger type 2 inflammatory responses in the upper and lower airways. This novel concept of a S. aureus-driven chronic airway inflammatory disease suggests a new understanding of disease triggers. This article reviews the role of S. aureus in chronic inflammatory airway diseases and discusses possible therapeutic approaches to target S. aureus. S. aureus is a versatile bacterium, persistently colonizing the nasal mucosa of approximately one third of the general population.A significant association of S. aureus colonization and sensitization with chronic airway inflammation has long been observed. However, recent mechanistic studies provide emerging evidence for S. aureus being an inducer of type 2 immunity.This adds an infectious character to chronic inflammatory airway diseases such as asthma and chronic rhinosinusitis.Novel strategies for effective S. aureus elimination are currently being developed to restore homeostasis in some patient subgroups of chronic inflammatory airway diseases.