International Rhinologic Society Rhinology 0300-0729 2025 11 30 Identification of host-microbiome interactions in nasal diseases using multiomics integration EN Y. Liang Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Institute of Otolaryngology of Tianjin, Key Laboratory of Auditory Speech and Balance Medicine, Key Medical Discipline of Tianjin (Otolaryngology), Quality Control Centre of Otolaryngology, Tianjin, China Z. Chen LC-BIO Technologies CO., LTD., Hangzhou, China C. ZhangDepartment of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Institute of Otolaryngology of Tianjin, Key Laboratory of Auditory Speech and Balance Medicine, Key Medical Discipline of Tianjin (Otolaryngology), Quality Control Centre of Otolaryngology, Tianjin, China Department of Head and Neck Tumor Surgery, Shanxi Provincial People's Hospital, Shanxi, China Z. Li Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Institute of Otolaryngology of Tianjin, Key Laboratory of Auditory Speech and Balance Medicine, Key Medical Discipline of Tianjin (Otolaryngology), Quality Control Centre of Otolaryngology, Tianjin, China J. Liu Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Institute of Otolaryngology of Tianjin, Key Laboratory of Auditory Speech and Balance Medicine, Key Medical Discipline of Tianjin (Otolaryngology), Quality Control Centre of Otolaryngology, Tianjin, China W. Sun LC-BIO Technologies CO., LTD., Hangzhou, China J. Li LC-BIO Technologies CO., LTD., Hangzhou, China J. Zhi Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Institute of Otolaryngology of Tianjin, Key Laboratory of Auditory Speech and Balance Medicine, Key Medical Discipline of Tianjin (Otolaryngology), Quality Control Centre of Otolaryngology, Tianjin, China G. Zhang Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Institute of Otolaryngology of Tianjin, Key Laboratory of Auditory Speech and Balance Medicine, Key Medical Discipline of Tianjin (Otolaryngology), Quality Control Centre of Otolaryngology, Tianjin, China Journal Article 3341 10.4193/Rhin24.386 Background: Nasal dysbiosis is implicated in the pathogenesis of nasal diseases, yet microbiome-host interplay remains poorly understood. Methodology: We conducted a cross-sectional analysis comparing 43 CRSwNP patients, 27 NIP patients, and 34 controls using dual 5R 16S rRNA sequencing and host transcriptomics to characterize microbiome profiles and host-microbial interactions. Results: Distinct microbiome patterns were identified in CRSwNP and NIP mucosal microenvironments. Host-microbiome interaction analysis revealed both shared and disease-specific associations. Common to both disorders were immune-related pathway enrichments, while CRSwNP uniquely demonstrated microbial recognition/immune activation links and NIP showed predominant proliferative pathway correlations. Notably, Bayesian network analysis identified Geobacillus stearothermophilus abundance as significantly associated with NF-κB pathway activation in nasal polyps - a finding subsequently experimentally validated. Conclusion: Our findings delineate disease-specific microbiome-host interplay in nasal pathologies, with CRSwNP exhibiting immune-focused interactions versus NIP's proliferative associations. These insights advance our understanding of nasal disease mechanisms and support the development of targeted microbiome-modulating therapies.