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Dupilumab treatment in patients with CRSwNP led to a healthier nasal microbiota by increasing beneficial bacteria like Lawsonella and Corynebacterium. The gut microbiota showed no effect, indicating dupilumab’s localized impact on nasal inflammation. 

According to the study published in the June 2025 issue of European Journal of Allergy and Clinical Immunology, researchers analyzed the longitudinal effects of dupilumab on nasal and gastrointestinal microbiota in individuals with diffuse type 2 chronic rhinosinusitis with nasal polyps (CRSwNP). 

They included 27 patients with diffuse type 2 CRSwNP who received dupilumab 300 mg subcutaneously every 2 weeks. The study also incorporated 10 untreated patients with CRSwNP and 11 healthy controls. Nasal and stool samples were collected from the treated CRSwNP group on Days 0, 28, 90, and 180 post-treatments. For the untreated CRSwNP and healthy control groups, samples were obtained on Days 0 and 28. Subsequently, all samples were analyzed using 16S rRNA gene amplicon sequencing (V3/V4).  

The results showed that patients with CRSwNP , the most abundant genera in the nasal passage microbiota were Corynebacterium and Staphylococcus. Cutibacterium and Lawsonella were less abundant in CRSwNP at baseline compared to healthy controls. Dupilumab treatment was associated with increased relative abundances of genera such as Lawsonella, Corynebacterium, and Dolosigranulum in the nasal passage. The microbial diversity of the gastrointestinal microbiota in CRSwNP at baseline was more elevated than in healthy controls. No changes were observed in the gastrointestinal microbiota during dupilumab treatment.  

Investigators concluded that dupilumab treatment shifted the nasal passage bacterial microbiota toward that of healthy controls, while the gastrointestinal microbiota composition remained unchanged, suggesting an influence of the underlying inflammatory endotype on nasal passage microbiota. 

Source: onlinelibrary.wiley.com/doi/10.1111/all.16600