THE ROLE OF THE NASOPHARYNGEAL MICROBIOME IN THE FORMATION OF CHRONIC AND RECURRENT ENT DISEASES IN CHILDREN: CLINICAL SIGNIFICANCE AND PROSPECTS OF PERSONALIZED THERAPY

Abstract

The review summarizes current data on the role of the nasopharyngeal microbiome in the development of chronic and recurrent ENT diseases in children, with a particular focus on microbiome-associated biomarkers, host genetic factors, and mechanisms of immune regulation. It has been demonstrated that dysbiosis of the nasopharyngeal microbiota is closely associated with the pathogenesis of adenoiditis, otitis media, rhinosinusitis, and allergic rhinitis, influencing both local mucosal immunity and systemic inflammatory responses. The paper analyzes age-related features of microbiome formation, the interaction between microbial communities and innate and adaptive immunity, as well as the impact of early-life environmental and postnatal factors on microbial colonization. Special attention is given to the role of genetic predisposition in shaping microbial composition and susceptibility to recurrent ENT pathology. Current evidence regarding the association between host genomic variability, immune-response genes, and microbiome diversity is discussed. Modern molecular and metagenomic methods for microbiome assessment, including sequencing technologies and identification of microbial and inflammatory biomarkers, are reviewed together with their clinical interpretation and diagnostic potential. The presented data support the concept that microbiome-derived and genetic biomarkers may become an important basis for personalized approaches to prediction, prevention, and targeted therapy of pediatric ENT diseases. The integration of microbiome profiling into clinical practice is considered a promising direction for precision medicine in pediatric otorhinolaryngology.