{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T03:18:46Z","timestamp":1787627926754,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82501376"],"award-info":[{"award-number":["82501376"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100032579","name":"Beijing Medical Award Foundation","doi-asserted-by":"publisher","award":["YXL\u20102021\u20100387\u20100752"],"award-info":[{"award-number":["YXL\u20102021\u20100387\u20100752"]}],"id":[{"id":"10.13039\/100032579","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) exhibit heterogeneous responses to oral glucocorticoids (GCs), but the biological basis of this variability remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify gut microbiome\u2012plasma metabolomic signatures associated with GC responsiveness in CRSwNP patients and to compare their predictive value with that of conventional clinical indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with CRSwNP aged 18\u201365 years with bilateral nasal polyps and a nasal polyp score (NPS)\u00a0\u2265\u00a02 on at least one side were enrolled, together with septoplasty controls without sinonasal disease. GC responsiveness was defined as the change in endoscopic NPS after 2 weeks of oral methylprednisolone. Fecal shotgun metagenomic and untargeted plasma metabolomics were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010six CRSwNP patients and 30 controls were included. At baseline, GC responders had significantly greater tissue eosinophilic inflammation, whereas GC non\u2010responders had higher NPS. Responders exhibited distinct baseline gut microbial and plasma metabolic profiles, characterized by the enrichment of\n                      <jats:italic>Bacteroides caccae<\/jats:italic>\n                      ,\n                      <jats:italic>Microbacterium flavum<\/jats:italic>\n                      , and\n                      <jats:italic>Mucilaginibacter rigui<\/jats:italic>\n                      , and markedly elevated levels of lupinisoflavone N, CAY10622, kanzonol V, and D\u2010sorbitol. These baseline features were positively correlated with tissue eosinophilic inflammation. After treatment, reductions in Lund\u2013Mackay CT total score, ethmoid\/maxillary sinus CT score ratio, NPS, tissue eosinophilic inflammation, and tissue IL\u20106 mRNA levels were significantly greater in GC responders. Tissue eosinophil count was the strongest conventional predictor (AUC\u00a0=\u00a00.885), while the integrated multiomics model achieved an AUC of 0.899, showing only marginal improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Gut microbiome\u2013plasma metabolomic signatures capture the systemic immunometabolic context of GC therapy and are linked to GC responsiveness in CRSwNP, explaining interindividual treatment efficacy differences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70246","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T02:25:57Z","timestamp":1787624757000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Microbial\u2010Metabolite Signatures Are Associated With Glucocorticoid Responsiveness in Chronic Rhinosinusitis With Nasal Polyps"],"prefix":"10.1002","author":[{"given":"Ying\u2010Ying","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology The First Affiliated Hospital with Nanjing Medical University  Nanjing China"},{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin\u2010Yu","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Longhua Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei\u2010Ping","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology The First Affiliated Hospital with Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010Bing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology The First Affiliated Hospital with Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology The First Affiliated Hospital with Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology The First Affiliated Hospital with Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology The First Affiliated Hospital with Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6541-7702","authenticated-orcid":false,"given":"Lei","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology The First Affiliated Hospital with Nanjing Medical University  Nanjing China"},{"name":"Department of Allergology &amp; 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