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Wu K, Li Y, Ma K, Zhao W, Yao Z, Zheng Z, Sun F, Mu X, Liu Z, Zheng J. The microbiota and renal cell carcinoma. Cell Oncol (Dordr) 2024; 47:397-413. [PMID: 37878209 DOI: 10.1007/s13402-023-00876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2023] [Indexed: 10/26/2023] Open
Abstract
Renal cell carcinoma (RCC) accounts for about 2% of cancer diagnoses and deaths worldwide. Recent studies emphasized the critical involvement of microbial populations in RCC from oncogenesis, tumor growth, and response to anticancer therapy. Microorganisms have been shown to be involved in various renal physiological and pathological processes by influencing the immune system function, metabolism of the host and pharmaceutical reactions. These findings have extended our understanding and provided more possibilities for the diagnostic or therapeutic development of microbiota, which could function as screening, prognostic, and predictive biomarkers, or be manipulated to prevent RCC progression, boost anticancer drug efficacy and lessen the side effects of therapy. This review aims to present an overview of the roles of microbiota in RCC, including pertinent mechanisms in microbiota-related carcinogenesis, the potential use of the microbiota as RCC biomarkers, and the possibility of modifying the microbiota for RCC prevention or treatment. According to these scientific findings, the clinical translation of microbiota is expected to improve the diagnosis and treatment of RCC.
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Affiliation(s)
- Ke Wu
- Institute of Molecular Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaorong Li
- Institute of Molecular Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kangli Ma
- Institute of Molecular Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiguang Zhao
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhixian Yao
- Institute of Molecular Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhong Zheng
- Institute of Molecular Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Sun
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingyu Mu
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihong Liu
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Junhua Zheng
- Institute of Molecular Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kustrimovic N, Bilato G, Mortara L, Baci D. The Urinary Microbiome in Health and Disease: Relevance for Bladder Cancer. Int J Mol Sci 2024; 25:1732. [PMID: 38339010 PMCID: PMC10855347 DOI: 10.3390/ijms25031732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
Bladder cancer (BC) constitutes one of the most diagnosed types of cancer worldwide. Advancements in and new methodologies for DNA sequencing, leading to high-throughput microbiota testing, have pinpointed discrepancies in urinary microbial fingerprints between healthy individuals and patients with BC. Although several studies suggest an involvement of microbiota dysbiosis in the pathogenesis, progression, and therapeutic response to bladder cancer, an established direct causal relationship remains to be elucidated due to the lack of standardized methodologies associated with such studies. This review compiles an overview of the microbiota of the human urinary tract in healthy and diseased individuals and discusses the evidence to date on microbiome involvement and potential mechanisms by which the microbiota may contribute to the development of BC. We also explore the potential profiling of urinary microbiota as a biomarker for risk stratification, as well as the prediction of the response to intravesical therapies and immunotherapy in BC patients. Further investigation into the urinary microbiome of BC patients is imperative to unravel the complexities of the role played by host-microbe interactions in shaping wellness or disease and yield valuable insights into and strategies for the prevention and personalized treatment of BC.
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Affiliation(s)
- Natasa Kustrimovic
- Center for Translational Research on Autoimmune and Allergic Disease—CAAD, Università del Piemonte Orientale, 28100 Novara, Italy;
| | - Giorgia Bilato
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy;
| | - Lorenzo Mortara
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy;
| | - Denisa Baci
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy;
- Molecular Cardiology Laboratory, IRCCS—Policlinico San Donato, 20097 Milan, Italy
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3
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Bladder cancer-associated microbiota: Recent advances and future perspectives. Heliyon 2023; 9:e13012. [PMID: 36704283 PMCID: PMC9871226 DOI: 10.1016/j.heliyon.2023.e13012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/30/2022] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Recent evidence suggests that the human genitourinary microbiome plays a significant role in mediating the development and progression of urological tumors, including bladder cancer (BC). Clinicians widely recognize the role of Bacille Calmette Guérin (BCG), an attenuated Mycobacterium tuberculosis vaccine, in the management of intermediate- and high-risk NMIBC. However, compared to the large body of evidence on the gut microbiota and gastrointestinal tumors, limited information is available about the interaction between BC and the genitourinary microbiome. This is an expanding field that merits further investigation. Urologists will need to consider the potential impact of the microbiome in BC diagnosis, prevention of recurrence and progression, and treatment prospects in the future. This review highlights the approaches adopted for microbiome research and the findings and inadequacies of current research on BC.
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Kim JK, Song SH, Jung G, Song B, Hong SK. Possibilities and limitations of using low biomass samples for urologic disease and microbiome research. Prostate Int 2022; 10:169-180. [PMID: 36570648 PMCID: PMC9747588 DOI: 10.1016/j.prnil.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 11/12/2022] Open
Abstract
With the dogma of sterile urine no longer held as truth, numerous studies have implicated distinct changes in microbial diversity and composition to diseased subgroups in both benign and malignant urological diseases, ranging from overactive bladder to bladder and prostate cancer. Further facilitated by novel and effective techniques of urine culture and sequencing, analysis of the genitourinary microbiome holds high potential to identify biomarkers for disease and prognosis. However, the low biomass of samples included in microbiome studies of the urinary tract challenge researchers to draw definitive conclusions, confounded by technical and procedural considerations that must be addressed. Lack of samples and adequate true negative controls can lead to overestimation of microbial influence with clinical relevance. As such, results from currently available studies and assessment of their limitations required a thorough understanding. The purpose of this narrative review was to summarize notable microbiome studies in the field of urology with a focus on significant findings and limitations of study design. Methodological considerations in future research are also discussed.
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Affiliation(s)
- Jung Kwon Kim
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea,Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Hun Song
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Gyoohwan Jung
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byeongdo Song
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea,Department of Urology, Seoul National University College of Medicine, Seoul, Korea,Corresponding author. Department of Urology, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, Korea.
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5
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Yacouba A, Tidjani Alou M, Lagier JC, Dubourg G, Raoult D. Urinary microbiota and bladder cancer: A systematic review and a focus on uropathogens. Semin Cancer Biol 2022; 86:875-884. [PMID: 34979272 DOI: 10.1016/j.semcancer.2021.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/14/2021] [Accepted: 12/25/2021] [Indexed: 01/27/2023]
Abstract
The higher incidence of bladder cancer in men has long been attributed to environmental factors, including smoking. The fact that the sex ratio of bladder cancer remains consistently weighted toward men despite the remarkable increase in the prevalence of smoking among women suggests that other risk factors influence the incidence rates of bladder cancer. These factors may include the urinary microbiota. In this study, we provide a review of recent literature regarding the association between bladder cancer and changes in the urinary microbiota, with a focus on the potential role of uropathogens in the microbiota and sex in bladder cancer. Four databases were systematically searched up to 31 March 2021 to identify human case-controlled studies that evaluated the relationship between urinary microbiota and bladder cancer. We combined bacterial taxa that were significantly higher or lower in the bladder cancer group in each study in the urine (voided and catheterized) and tissue samples. Findings from sixteen eligible studies were analyzed. The total sample size of the included studies was 708 participants, including 449 (63.4 %) bladder cancer patients and 259 (36.6 %) participants in the control group. When considering only the taxa that have been reported in at least two different studies, we observed that with regards to neoplastic tissues, no increased taxa were reported, while Lactobacillus (2/5 of the studies on tissue samples) was increased in nonneoplastic-tissue compared to neoplastic-tissues at the genus level. In catheterized urine, Veillonella (2/3 of the studies on catheterized urine) was increased in bladder cancer patients compared to the control groups at the genus level. In voided urine, Acinetobacter, Actinomyces, Aeromonas, Anaerococcus, Pseudomonas, and Tepidomonas were increased in the bladder cancer patients, while Lactobacillus, Roseomonas, Veillonella were increased in the control groups. Regarding gender, the genus Actinotignum was increased in female participants while Streptococcus was increased in male participants at the genus level. Regarding potential uropathogens in the urinary microbiota, Escherichia-Shigella provided conflicting results, with both showing higher and lower levels in the bladder cancer groups. However, the family Enterobacteriaceae was lower in the bladder cancer groups than in the control groups. In conclusion, there is no consensus on what taxa of the urinary microbiota are associated with bladder cancer according to the sample type. Findings on the potential role of uropathogens in the urinary microbiota in bladder cancer remain inconsistent. Due to the limited number of studies, further studies on urinary microbiota and bladder cancer are needed to address this issue. Given that all publications concerning the urinary microbiota and bladder cancer have been performed using 16S rRNA gene sequencing, we propose that polyphasic approaches, including culture-dependent techniques, may allow for a more comprehensive investigation of the urinary microbiota associated with bladder cancer.
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Affiliation(s)
- Abdourahamane Yacouba
- Aix Marseille Univ, IRD, Microbes, Evolution, Phylogeny and Infection (MEPHI), AP-HM, Marseille, France; IHU Méditerranée Infection, France; Université Abdou Moumouni, Niamey, Niger
| | - Maryam Tidjani Alou
- Aix Marseille Univ, IRD, Microbes, Evolution, Phylogeny and Infection (MEPHI), AP-HM, Marseille, France; IHU Méditerranée Infection, France
| | - Jean-Christophe Lagier
- Aix Marseille Univ, IRD, Microbes, Evolution, Phylogeny and Infection (MEPHI), AP-HM, Marseille, France
| | - Grégory Dubourg
- Aix Marseille Univ, IRD, Microbes, Evolution, Phylogeny and Infection (MEPHI), AP-HM, Marseille, France.
| | - Didier Raoult
- Aix Marseille Univ, IRD, Microbes, Evolution, Phylogeny and Infection (MEPHI), AP-HM, Marseille, France; IHU Méditerranée Infection, France.
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de Cock M, Fonville M, de Vries A, Bossers A, van den Bogert B, Hakze-van der Honing R, Koets A, Sprong H, van der Poel W, Maas M. Screen the unforeseen: Microbiome-profiling for detection of zoonotic pathogens in wild rats. Transbound Emerg Dis 2022; 69:3881-3895. [PMID: 36404584 PMCID: PMC10099244 DOI: 10.1111/tbed.14759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/30/2022] [Accepted: 11/01/2022] [Indexed: 11/22/2022]
Abstract
Wild rats can host various zoonotic pathogens. Detection of these pathogens is commonly performed using molecular techniques targeting one or a few specific pathogens. However, this specific way of surveillance could lead to (emerging) zoonotic pathogens staying unnoticed. This problem may be overcome by using broader microbiome-profiling techniques, which enable broad screening of a sample's bacterial or viral composition. In this study, we investigated if 16S rRNA gene amplicon sequencing would be a suitable tool for the detection of zoonotic bacteria in wild rats. Moreover, we used virome-enriched (VirCapSeq) sequencing to detect zoonotic viruses. DNA from kidney samples of 147 wild brown rats (Rattus norvegicus) and 42 black rats (Rattus rattus) was used for 16S rRNA gene amplicon sequencing of the V3-V4 hypervariable region. Blocking primers were developed to reduce the amplification of rat host DNA. The kidney bacterial composition was studied using alpha- and beta-diversity metrics and statistically assessed using PERMANOVA and SIMPER analyses. From the sequencing data, 14 potentially zoonotic bacterial genera were identified from which the presence of zoonotic Leptospira spp. and Bartonella tribocorum was confirmed by (q)PCR or Sanger sequencing. In addition, more than 65% of all samples were dominated (>50% reads) by one of three bacterial taxa: Streptococcus (n = 59), Mycoplasma (n = 39) and Leptospira (n = 25). These taxa also showed the highest contribution to the observed differences in beta diversity. VirCapSeq sequencing in rat liver samples detected the potentially zoonotic rat hepatitis E virus in three rats. Although 16S rRNA gene amplicon sequencing was limited in its capacity for species level identifications and can be more difficult to interpret due to the influence of contaminating sequences in these low microbial biomass samples, we believe it has potential to be a suitable pre-screening method in the future to get a better overview of potentially zoonotic bacteria that are circulating in wildlife.
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Affiliation(s)
- Marieke de Cock
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Manoj Fonville
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ankje de Vries
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Alex Bossers
- Wageningen Bioveterinary Research (WBVR), Lelystad, The Netherlands.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | | | | | - Ad Koets
- Wageningen Bioveterinary Research (WBVR), Lelystad, The Netherlands.,Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Hein Sprong
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Wim van der Poel
- Wageningen Bioveterinary Research (WBVR), Lelystad, The Netherlands
| | - Miriam Maas
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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7
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Zerdan MB, Moukarzel R, Naji NS, Bilen Y, Nagarajan A. The Urogenital System’s Role in Diseases: A Synopsis. Cancers (Basel) 2022; 14:cancers14143328. [PMID: 35884388 PMCID: PMC9319963 DOI: 10.3390/cancers14143328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The urinary tract microbiome has come under a lot of scrutiny, and this has led to the rejection of the pre-established concept of sterility in the urinary bladder. Microbial communities in the urinary tract have been implicated in the maintenance of health. Thus, alterations in their composition have also been associated with different urinary pathologies, such as urinary tract infections. For that reason, tackling the urinary microbiome of healthy individuals, as well as its involvement in disease through the proliferation of opportunistic pathogens, could open a potential field of study, leading to new insights into prevention, diagnosis, and treatment strategies for different diseases. Abstract The human microbiota contains ten times more microbial cells than human cells contained by the human body, constituting a larger genetic material than the human genome itself. Emerging studies have shown that these microorganisms represent a critical determinant in human health and disease, and the use of probiotic products as potential therapeutic interventions to modulate homeostasis and treat disease is being explored. The gut is a niche for the largest proportion of the human microbiota with myriad studies suggesting a strong link between the gut microbiota composition and disease development throughout the body. More specifically, there is mounting evidence on the relevance of gut microbiota dysbiosis in the development of urinary tract disease including urinary tract infections (UTIs), chronic kidney disease, and kidney stones. Fewer emerging reports, however, are suggesting that the urinary tract, which has long been considered ‘sterile’, also houses its unique microbiota that might have an important role in urologic health and disease. The implications of this new paradigm could potentially change the therapeutic perspective in urological disease.
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Affiliation(s)
- Maroun Bou Zerdan
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA;
- Department of Hematology and Oncology, Cleveland Clinic Florida, Weston, FL 33331, USA
| | - Rita Moukarzel
- Faculty of Medicine, Lebanese American University Medical Center, Lebanese American University, Beirut 1102, Lebanon;
| | - Nour Sabiha Naji
- Faculty of Medicine, American University of Beirut, Beirut 2020, Lebanon;
| | - Yara Bilen
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA;
| | - Arun Nagarajan
- Department of Hematology and Oncology, Cleveland Clinic Florida, Weston, FL 33331, USA
- Correspondence:
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Bradley ES, Schell B, Ward DV, Bucci V, Zeamer A, Haran JP. The Urinary Microbiome of Older Adults Residing in a Nursing Home Varies With Duration of Residence and Shows Increases in Potential Pathogens. J Gerontol A Biol Sci Med Sci 2022; 77:1313-1320. [PMID: 34791238 PMCID: PMC9653004 DOI: 10.1093/gerona/glab345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
The community of bacteria that colonize the urinary tract, the urinary microbiome, is hypothesized to influence a wide variety of urinary tract conditions. Older adults who reside in nursing homes are frequently diagnosed and treated for urinary tract conditions such as urinary tract infection. We investigated the urinary microbiome of older adults residing in a nursing home to determine if there are features of the urinary microbiome that are associated with specific conditions and exposure in this population. We were also interested in the stability of urinary microbiome over time and in similarities between the urinary and gastrointestinal microbiome. Urine samples were prospectively collected over a period of 10 months from a cohort of 26 older adults (aged >65 years) residing in a single nursing home located in Central Massachusetts. Serial samples were obtained from 6 individuals over 10 months and 5 participants were concurrently enrolled in a study of the gastrointestinal microbiome. Information collected on participants included demographics, medical history, duration of residence in the nursing home, frailty, dementia symptoms, urinary symptoms, antibiotic treatment, urinary catheterization, and hospitalizations over a 10-month period. Clean catch, midstream urine samples were collected and stored at -80°C. DNA was extracted and 16S rRNA gene sequencing was performed. The length of stay in the nursing facility and the Clinical Frailty Scale correlated with significant changes in microbiome composition. An increase in the relative abundance of a putative urinary pathogen, Aerococcus urinae, was the largest factor influencing change that occurred over the duration of residence.
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Affiliation(s)
- Evan S Bradley
- Department of Emergency Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Program in Microbiome Dynamics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Brent Schell
- Department of Emergency Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Doyle V Ward
- Program in Microbiome Dynamics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Department of Microbiology and Physiological Systems, Center for Microbiome Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Vanni Bucci
- Program in Microbiome Dynamics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Department of Microbiology and Physiological Systems, Center for Microbiome Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Abigail Zeamer
- Department of Microbiology and Physiological Systems, Center for Microbiome Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - John P Haran
- Department of Emergency Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Program in Microbiome Dynamics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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The Microbiome and Urolithiasis: Current Advancements and Future Challenges. Curr Urol Rep 2022; 23:47-56. [PMID: 35138598 DOI: 10.1007/s11934-022-01088-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The aim of this review is to explore the effect of the microbiome on urolithiasis and explore recent advances and challenges in microbiome research for urolithiasis. RECENT FINDINGS Lack of standardization and shortcomings in study design for urinary microbiome research on urolithiasis has hampered the generalizability of results and weakened the impact of findings on clinical practice. Important study limitations include sample heterogenicity, specimen contamination, poor culture yields, and lack of shared datasets for meta-analysis. Contrary to traditional teaching, the genitourinary tract is not a sterile environment. This urinary microbiome may influence the pathogenesis of urolithiasis, although the specific mechanisms are still currently being explored. Successful investigation will depend on consistency in study design and analysis, as well as sharing data and protocols across institutions. Developing an understanding of the relationship between the urinary microbiome and urolithiasis may lead to novel approaches to mitigate stone risk.
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10
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Javier-DesLoges J, McKay RR, Swafford AD, Sepich-Poore GD, Knight R, Parsons JK. The microbiome and prostate cancer. Prostate Cancer Prostatic Dis 2022; 25:159-164. [PMID: 34267333 PMCID: PMC8767983 DOI: 10.1038/s41391-021-00413-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/24/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022]
Abstract
There is growing evidence that the microbiome is involved in development and treatment of many human diseases, including prostate cancer. There are several potential pathways for microbiome-based mechanisms for the development of prostate cancer: direct impacts of microbes or microbial products in the prostate or the urine, and indirect impacts from microbes or microbial products in the gastrointestinal tract. Unique microbial signatures have been identified within the stool, oral cavity, tissue, urine, and blood of prostate cancer patients, but studies vary in their findings. Recent studies describe potential diagnostic and therapeutic applications of the microbiome, but further clinical investigation is needed. In this review, we explore the existing literature on the discovery of the human microbiome and its relationship to prostate cancer.
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Affiliation(s)
| | - Rana R McKay
- Department of Urology, UC San Diego Health, La Jolla, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UC San Diego Health, La Jolla, CA, USA
| | | | | | - Rob Knight
- Department of Bioengineering, UC San Diego, La Jolla, CA, USA
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Biehl LM, Farowski F, Hilpert C, Nowag A, Kretzschmar A, Jazmati N, Tsakmaklis A, Wieters I, Khodamoradi Y, Wisplinghoff H, Vehreschild MJGT. Longitudinal variability in the urinary microbiota of healthy premenopausal women and the relation to neighboring microbial communities: A pilot study. PLoS One 2022; 17:e0262095. [PMID: 35030190 PMCID: PMC8759677 DOI: 10.1371/journal.pone.0262095] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 12/17/2021] [Indexed: 12/20/2022] Open
Abstract
Background The understanding of longitudinal changes in the urinary microbiota of healthy women and its relation to intestinal microbiota is limited. Methods From a cohort of 15 premenopausal women without known urogenital disease or current symptoms, we collected catheter urine (CU), vaginal and periurethral swabs, and fecal samples on four visits over six months. Additionally, ten participants provided CU and midstream urine (MU) to assess comparability. Urine was subjected to expanded culture. 16S rRNA gene sequencing was performed on all urine, fecal, and selected vaginal and periurethral samples. Sequence reads were processed (DADA2 pipeline) and analyzed using QIIME 2 and R. Results Relative abundances of urinary microbiota were variable over 6–18 months. The degree of intraindividual variability of urinary microbiota was higher than that found in fecal samples. Still, nearly half of the observed beta diversity of all urine samples could be attributed to differences between volunteers (R2 = 0.48, p = 0.001). After stratification by volunteer, time since last sexual intercourse was shown to be a factor significantly contributing to beta diversity (R2 = 0.14, p = 0.001). We observed a close relatedness of urogenital microbial habitats and a clear distinction from intestinal microbiota in the overall betadiversity analysis. Microbiota compositions derived from MU differed only slightly from CU compositions. Within this analysis of low-biomass samples, we identified contaminating sequences potentially stemming from sequencing reagents. Conclusions Results from our longitudinal cohort study confirmed the presence of a rather variable individual urinary microbiota in premenopausal women. These findings from catheter urine complement previous observations on temporal dynamics in voided urine. The higher intraindividual variability of urinary microbiota as compared to fecal microbiota will be a challenge for future studies investigating associations with urogenital diseases and aiming at identifying pathogenic microbiota signatures.
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Affiliation(s)
- Lena M. Biehl
- Faculty of Medicine and University Hospital of Cologne, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- German Centre for Infection Research, Bonn-Cologne, Germany
| | - Fedja Farowski
- Faculty of Medicine and University Hospital of Cologne, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- German Centre for Infection Research, Bonn-Cologne, Germany
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Catharina Hilpert
- Faculty of Medicine and University Hospital of Cologne, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - Angela Nowag
- Wisplinghoff laboratories, Cologne, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany
| | | | - Nathalie Jazmati
- Wisplinghoff laboratories, Cologne, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany
| | - Anastasia Tsakmaklis
- Faculty of Medicine and University Hospital of Cologne, Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - Imke Wieters
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Yascha Khodamoradi
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Hilmar Wisplinghoff
- Wisplinghoff laboratories, Cologne, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany
- Institute for Virology and Medical Microbiology, Witten/Herdecke University, Witten, Germany
| | - Maria J. G. T. Vehreschild
- Faculty of Medicine and University Hospital of Cologne, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- German Centre for Infection Research, Bonn-Cologne, Germany
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- * E-mail:
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Wang C, Dong X, Yin X, Zhou F. Impact of intestinal flora on calcium oxalate stones. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2021; 46:1285-1289. [PMID: 34911864 PMCID: PMC10929843 DOI: 10.11817/j.issn.1672-7347.2021.200513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Indexed: 11/03/2022]
Abstract
Kidney stone is one of the common diseases of the urinary system. About 80% of kidney stones are mainly composed of calcium oxalate. As a huge bacterial network, the interaction of gut microbes is complex. Intestinal microbes may play a role in the pathogenesis and prevention of kidney stones. The intestinal flora of patients with calcium oxalate stones possess unique distribution of gut microbes. Oxalobacter formigenes, Bifidobacterium, Lactobacillus, Escherichia coli, and Providencia reteri bacteria are closely related to calcium oxalate stones, which provides new ideas for the prevention and treatment of urinary stones.
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Affiliation(s)
- Chao Wang
- First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000.
| | - Xu Dong
- First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000
| | - Xinwei Yin
- First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000
| | - Fenghai Zhou
- Department of Urology, Gansu Provincial People's Hospital, Lanzhou 730000, China.
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13
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Torres Luque A, Fontana C, Pasteris SE, Bassi D, Cocconcelli PS, Otero MC. Bacterial communities associated to the urethra of healthy gilts and pregnant sows undergoing different reproductive protocols. J Anim Sci 2020; 98:5890613. [PMID: 32777034 DOI: 10.1093/jas/skaa258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2020] [Indexed: 12/15/2022] Open
Abstract
Nowadays, it is known that the urogenital microbiota plays a key role in the urinary health of mammalians. Despite the urinary infections affect the health and the welfare of breeding sows, the urethral microbiota of healthy sows remains unknown. Therefore, this work evaluates the urethral bacterial communities of healthy gilts and sows to determine the presence of Enterobacteriaceae populations, and the structure of this microbiota in gilts (G) and pregnant (P) sows. Samples were collected by scraping the urethral mucosa of G (n = 9) and P sows, which included natural mating (NM, n = 9) and artificial inseminated (AI, n = 7) sows. Samples were analyzed by culture-dependent techniques and 16S-rRNA gene high-throughput-sequencing. All females were positive for Enterobacteriaceae culture, without significant differences (Kruskal-Wallis) between G and P groups (median values: 2.78 and 3.09 log CFU/mL, respectively; P = 0.497). Also, the rate of Enterobacteriaceae/total mesophilic microorganisms was individually calculated, without significant differences between G and P sows (median values: 0.61 and 0.66, respectively; P = 0.497). When analyzing the bacterial communities, it was found similar richness in G, NM, and AI; however, diversity was lower in P sows than G (Mann Whitney/Kruskal-Wallis test, P < 0.01). The dominating phyla that constituted a "core microbiome" included Firmicutes, Proteobacteria, Cyanobacteria, Actinobacteria, and Bacteroidetes, which were common for all the studied females. The relative abundance for phyla, families, and genera was estimated, and Firmicutes was significantly higher in NM than AI sows (P = 0.02, Mann-Whitney/Kruskal Wallis test for univariate statistical comparisons); Pseudomonadaceae and Enterobacteriaceae were higher in AI than in NM (Mann-Whitney/Kruskal-Wallis, P < 0.05). Lactobacillus and Pseudomonas were among the dominant genera; however, only Pseudomonas sp. was significantly higher in AI than NM (Mann-Whitney/Kruskal-Wallis, P = 0.006). The results represent the first evidence about the existence of a urethral microbiota that includes Enterobacteriaceae, as well as the patterns of this microbiota in G and P sows. The knowledge of this urethral microbiota might allow for future research to develop innovative protocols to restore and/or preserve the healthy ecology of the urinary microbiome to prevent diseases ensuring the welfare of breeding sows.
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Affiliation(s)
- Andrea Torres Luque
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Instituto de Biología "Dr. Francisco D. Barbieri", Facultad de Bioquímica, Química y Farmacia, UNT, Chacabuco 461, San Miguel de Tucumán, Argentina
| | - Cecilia Fontana
- Estación Experimental Agropecuaria Famaillá INTA, Famaillá, Tucumán, Argentina
| | - Sergio E Pasteris
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Instituto de Biología "Dr. Francisco D. Barbieri", Facultad de Bioquímica, Química y Farmacia, UNT, Chacabuco 461, San Miguel de Tucumán, Argentina
| | - Daniela Bassi
- Dipartimento di Scienze e Tecnologie Alimentari per una filiera agro-alimentare Sostenibile (DISTAS), Università Cattolica del Sacro Cuore, Cremona-Piacenza, Italy
| | - Pier S Cocconcelli
- Dipartimento di Scienze e Tecnologie Alimentari per una filiera agro-alimentare Sostenibile (DISTAS), Università Cattolica del Sacro Cuore, Cremona-Piacenza, Italy
| | - María C Otero
- Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, and Instituto de Biología "Dr. Francisco D. Barbieri", Facultad de Bioquímica, Química y Farmacia, UNT, Chacabuco 461, San Miguel de Tucumán, Argentina
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14
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Ferreira RDS, Mendonça LABM, Ribeiro CFA, Calças NC, Guimarães RDCA, Nascimento VAD, Gielow KDCF, Carvalho CME, Castro APD, Franco OL. Relationship between intestinal microbiota, diet and biological systems: an integrated view. Crit Rev Food Sci Nutr 2020; 62:1166-1186. [PMID: 33115284 DOI: 10.1080/10408398.2020.1836605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The health-disease process can be influenced by the intestinal microbiota. As this plays a fundamental role in protecting the organism, the importance of studying the composition and diversity of this community becomes increasingly evident. Changes in the composition of the intestinal bacterial community may result in dysbiosis, and this process may contribute to triggering various diseases in all biological systems. This imbalance of intestinal microbiota homeostasis may alter commensal bacteria and the host metabolism, as well as immune function. Dysbiosis also causes an increase in intestinal permeability due to exposure to molecular patterns associated with the pathogen and lipopolysaccharides, leading to a chronic inflammatory process that can result in diseases for all biological systems. In this context, dietary intervention through the use of probiotics, prebiotics and antioxidant foods can be considered a contribution to the modulation of intestinal microbiota. Probiotics have been used to provide up to 10 billion colony forming units, and probiotic foods, Kefir and fermented natural yogurt are also used. Prebiotics, in turn, are found in supplemental formulations of processed foods and in functional foods that are also sources of phenolic compounds, such as flavonoids, antioxidant and anti-inflammatory substances, polyunsaturated fatty acids, vitamins, and minerals. In this review, we will discuss the relationship between an imbalance in the intestinal microbiota with the development of diseases, besides indicating the need for future studies that can establish bacterial parameters for the gastrointestinal tract by modulating the intestinal microbiota, associated with the adoption of healthy habits during all life cycles.
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Affiliation(s)
- Rosângela Dos Santos Ferreira
- S-Inova Biotech, Post Graduate Program in Biotechnology, Catholic University Dom Bosco, Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Camila Fontoura Acosta Ribeiro
- S-Inova Biotech, Post Graduate Program in Biotechnology, Catholic University Dom Bosco, Campo Grande, Mato Grosso do Sul, Brazil
| | - Natali Camposano Calças
- S-Inova Biotech, Post Graduate Program in Biotechnology, Catholic University Dom Bosco, Campo Grande, Mato Grosso do Sul, Brazil
| | - Rita de Cássia Avellaneda Guimarães
- Post Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Valter Aragão do Nascimento
- Post Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Karine de Cássia Freitas Gielow
- Post Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Alinne Pereira de Castro
- S-Inova Biotech, Post Graduate Program in Biotechnology, Catholic University Dom Bosco, Campo Grande, Mato Grosso do Sul, Brazil
| | - Octávio Luiz Franco
- S-Inova Biotech, Post Graduate Program in Biotechnology, Catholic University Dom Bosco, Campo Grande, Mato Grosso do Sul, Brazil.,Center of Proteomic and Biochemical Analysis, Post Graduate Program in Genomic Sciences and Biotechnology, Catholic University of Brasilia, Brasilia, Distrito Federal, Brazil
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15
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Biobanks for life sciences and personalized medicine: importance of standardization, biosafety, biosecurity, and data management. Curr Opin Biotechnol 2020; 65:45-51. [DOI: 10.1016/j.copbio.2019.12.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023]
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16
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Kinneman L, Zhu W, Wong WSW, Clemency N, Provenzano M, Vilboux T, Jane't K, Seo-Mayer P, Levorson R, Kou M, Ascher D, Niederhuber JE, Hourigan SK. Assessment of the Urinary Microbiome in Children Younger Than 48 Months. Pediatr Infect Dis J 2020; 39:565-570. [PMID: 32091499 DOI: 10.1097/inf.0000000000002622] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The urinary tract was once thought to be sterile, and little is known about the urinary microbiome in children. This study aimed to examine the urinary microbiome of young children across demographic and clinical factors. METHODS Children <48 months, undergoing a urinary catheterization for clinical purposes in the Pediatric Emergency Department were recruited and urine samples collected. Detailed demographic and clinical information were recorded. Urine samples underwent DNA extraction and 16S ribosomal RNA gene sequencing, urinalysis and urine culture. RESULTS Eighty-five children were included; a urinary microbiome was identified in every child. Nine children had Escherichia coli urinary tract infections (UTIs) identified. Those with UTIs had a significantly decreased alpha diversity (t test, P < 0.001) and the composition of the microbiome clustered separately (P = 0.001) compared with those without UTIs. CONCLUSIONS A urinary microbiome was identified in every child, even neonates. Differences in microbiome diversity and composition were observed in patients with a standard culture positive UTI. The urinary microbiome has just begun to be explored, and the implications on long-term disease processes deserve further investigation.
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Affiliation(s)
- Lauren Kinneman
- From the Department of Pediatrics and Department of Emergency Medicine, Inova Children's Hospital, Falls Church, VA.,Division of Emergency Medicine, Department of Pediatrics, University of Washington, Seattle, WA.,Seattle Children's Emergency Department, Seattle, WA
| | - Wei Zhu
- Seattle Children's Emergency Department, Seattle, WA
| | - Wendy S W Wong
- Inova Translational Medicine Institute, Falls Church, VA.,Seattle Children's Emergency Department, Seattle, WA
| | - Nicole Clemency
- Inova Translational Medicine Institute, Falls Church, VA.,Seattle Children's Emergency Department, Seattle, WA
| | - Marina Provenzano
- Inova Translational Medicine Institute, Falls Church, VA.,Seattle Children's Emergency Department, Seattle, WA
| | | | - Keary Jane't
- Inova Translational Medicine Institute, Falls Church, VA
| | - Patricia Seo-Mayer
- From the Department of Pediatrics and Department of Emergency Medicine, Inova Children's Hospital, Falls Church, VA.,Pediatric Specialists of Virginia, Falls Church, VA
| | - Rebecca Levorson
- From the Department of Pediatrics and Department of Emergency Medicine, Inova Children's Hospital, Falls Church, VA.,Pediatric Specialists of Virginia, Falls Church, VA
| | - Maybelle Kou
- From the Department of Pediatrics and Department of Emergency Medicine, Inova Children's Hospital, Falls Church, VA
| | - David Ascher
- From the Department of Pediatrics and Department of Emergency Medicine, Inova Children's Hospital, Falls Church, VA
| | - John E Niederhuber
- Inova Translational Medicine Institute, Falls Church, VA.,Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA
| | - Suchitra K Hourigan
- From the Department of Pediatrics and Department of Emergency Medicine, Inova Children's Hospital, Falls Church, VA.,Inova Translational Medicine Institute, Falls Church, VA.,Pediatric Specialists of Virginia, Falls Church, VA
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17
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Abstract
The discovery of bacteria in the female urinary bladder has fundamentally changed current dogma regarding the urinary tract and related urinary disorders. Previous research characterized many of the bacterial components of the female urinary tract, but the viral fraction of this community is largely unknown. Viruses within the human microbiota far outnumber bacterial cells, with the most abundant viruses being those that infect bacteria (bacteriophages). Similar to observations within the microbiota of the gut and oral cavity, preliminary surveys of the urinary tract and bladder microbiota indicate a rich diversity of uncharacterized bacteriophage (phage) species. Phages are vital members of the microbiota, having critical roles in shaping bacterial metabolism and community structure. Although phages have been discovered in the urinary tract, such as phages that infect Escherichia coli, sampling them is challenging owing to low biomass, possible contamination when using non-invasive methods and the invasiveness of methods that reduce the potential for contamination. Phages could influence bladder health, but an understanding of the association between phage communities, bacterial populations and bladder health is in its infancy. However, evidence suggests that phages can defend the host against pathogenic bacteria and, therefore, modulation of the microbiome using phages has therapeutic potential for lower urinary tract symptoms. Furthermore, as natural predators of bacteria, phages have garnered renewed interest for their use as antimicrobial agents, for instance, in the treatment of urinary tract infections.
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18
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Hourigan SK, Zhu W, S.W.Wong W, Clemency NC, Provenzano M, Vilboux T, Niederhuber JE, Deeken J, Chung S, McDaniel-Wiley K, Trump D. Studying the urine microbiome in superficial bladder cancer: samples obtained by midstream voiding versus cystoscopy. BMC Urol 2020; 20:5. [PMID: 31992287 PMCID: PMC6986141 DOI: 10.1186/s12894-020-0576-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 01/17/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Preliminary data suggest that the urinary microbiome may play a role in bladder cancer. Information regarding the most suitable method of collecting urine specimens is needed for the large population studies needed to address this. To compare microbiome metrics resulting from 16S ribosomal RNA gene sequencing between midstream, voided specimens and those obtained at cystoscopy. METHODS Adults, with a history of superficial urothelial cell carcinoma (non-muscle invasive bladder cancer) being followed with periodic surveillance cystoscopy had a urine sample collected by a mid-stream, voided technique and then from the bladder at cystoscopy. Urine samples underwent 16S ribosomal RNA gene sequencing on the Illumina MiSeq platform. RESULTS 22 subjects (8 female, 14 male) were included. There was no significant difference in beta diversity (diversity between samples) in all samples between collection methods. However, analysis by sex revealed a difference between voided and cystoscopy samples from the same individual in males (p = 0.006, Adonis test) but not in females (p = 0.317, Adonis test). No differences were seen by collection method in any alpha diversity (diversity within a sample) measurement or differential abundance of taxa. CONCLUSIONS Beta diversity of the urine microbiome did differ by collection method for males only. This suggests that the urinary microbiomes of the two collection methods are not equivalent to each other, at least in males, which is the sex that bladder cancer occurs most frequently in. Therefore, the same collection method within a given study should be used.
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Affiliation(s)
- Suchitra K. Hourigan
- Inova Children’s Hospital, 3300 Gallows Road, Falls Church, VA 22042 USA
- Inova Translational Medicine Institute, 3300 Gallows Road, Falls Church, VA 22042 USA
| | - Wei Zhu
- Inova Translational Medicine Institute, 3300 Gallows Road, Falls Church, VA 22042 USA
| | - Wendy S.W.Wong
- Inova Translational Medicine Institute, 3300 Gallows Road, Falls Church, VA 22042 USA
| | - Nicole C. Clemency
- Inova Translational Medicine Institute, 3300 Gallows Road, Falls Church, VA 22042 USA
| | - Marina Provenzano
- Inova Translational Medicine Institute, 3300 Gallows Road, Falls Church, VA 22042 USA
| | - Thierry Vilboux
- Inova Translational Medicine Institute, 3300 Gallows Road, Falls Church, VA 22042 USA
| | - John E. Niederhuber
- Inova Translational Medicine Institute, 3300 Gallows Road, Falls Church, VA 22042 USA
- Public Health Sciences, Center for Genomics in Public Health, School of Medicine, University of Virginia, Charlottesville, VA 22908 USA
| | - John Deeken
- Inova Translational Medicine Institute, 3300 Gallows Road, Falls Church, VA 22042 USA
- Public Health Sciences, Center for Genomics in Public Health, School of Medicine, University of Virginia, Charlottesville, VA 22908 USA
- Inova Schar Cancer Institute, 3224 Gallows Road, Fairfax, VA 22031 USA
| | - Simon Chung
- Inova Schar Cancer Institute, 3224 Gallows Road, Fairfax, VA 22031 USA
- Department of Urology, Inova Fairfax Medical Center, 3300 Gallows Road, Falls Church, VA 22042 USA
| | - Kim McDaniel-Wiley
- Department of Urology, Inova Fairfax Medical Center, 3300 Gallows Road, Falls Church, VA 22042 USA
| | - Donald Trump
- Inova Schar Cancer Institute, 3224 Gallows Road, Fairfax, VA 22031 USA
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19
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Ackerman AL, Chai TC. The Bladder is Not Sterile: an Update on the Urinary Microbiome. CURRENT BLADDER DYSFUNCTION REPORTS 2019; 14:331-341. [PMID: 32612735 DOI: 10.1007/s11884-019-00543-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose of Review The article discusses (1) techniques used to study bacterial urinary microbiota; (2) existence of non-bacterial urinary microbiota; (3) associations between changes in urinary microbiota and various benign lower urinary tract disorders. Recent Findings Urine harbors a diverse microbial community that resides within it. A multitude of studies have identified differences in these communities associated with urologic conditions, suggesting that microbial communities may maintain normal bladder homeostasis. Technological advances in analytic approaches have improved our understanding of the urinary microbiome. The choice of urine sampling method (voided, catheterized, or aspirated) will significantly influence microbiome findings. Sex and age highly influence urinary microbiota; in addition to rigorous inclusion criteria, microbial studies must be sufficiently powered to overcome the substantial interindividual variability of urinary microbiota. Regardless of these complicating factors, studies have identified microbial patterns correlating with both urologic diagnoses and treatment responses. Summary Without a clear understanding of the variability of and exogenous influences on the urinary microbiota in the absence of disease, it has been challenging to reveal the microbial patterns responsible for disease pathophysiology. Host mechanisms in response to the urinary microbiome are also poorly understood. Additional research can address whether the manipulation of urinary microbiota will benefit lower urinary tract health.
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Affiliation(s)
- A Lenore Ackerman
- Cedars-Sinai Medical Center, 99 N. La Cienega Blvd. Suite M102, Beverly Hills, CA 90211, USA
| | - Toby C Chai
- Boston Medical Center, Boston University School of Medicine, 725 Albany St., Suite 3B, Shapiro Building, Boston, MA 02118, USA
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20
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Jung CE, Chopyk J, Shin JH, Lukacz ES, Brubaker L, Schwanemann LK, Knight R, Wolfe AJ, Pride DT. Benchmarking urine storage and collection conditions for evaluating the female urinary microbiome. Sci Rep 2019; 9:13409. [PMID: 31527753 PMCID: PMC6746804 DOI: 10.1038/s41598-019-49823-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 08/27/2019] [Indexed: 12/12/2022] Open
Abstract
Standardized conditions for collection, preservation and storage of urine for microbiome research have not been established. We aimed to identify the effects of the use of preservative AssayAssure® (AA), and the effects of storage time and temperatures on reproducibility of urine microbiome results. We sequenced the V3-4 segment of the 16S rRNA gene to characterize the bacterial community in the urine of a cohort of women. Each woman provided a single voided urine sample, which was divided into aliquots and stored with and without AA, at three different temperatures (room temperature [RT], 4 °C, or -20 °C), and for various time periods up to 4 days. There were significant microbiome differences in urine specimens stored with and without AA at all temperatures, but the most significant differences were observed in alpha diversity (estimated number of taxa) at RT. Specimens preserved at 4 °C and -20 °C for up to 4 days with or without AA had no significant alpha diversity differences. However, significant alpha diversity differences were observed in samples stored without AA at RT. Generally, there was greater microbiome preservation with AA than without AA at all time points and temperatures, although not all results were statistically significant. Addition of AA preservative, shorter storage times, and colder temperatures are most favorable for urinary microbiome reproducibility.
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Affiliation(s)
- Carrie E Jung
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Diego, 92093, USA
| | - Jessica Chopyk
- Department of Pathology, University of California, San Diego, CA, 92093, USA
| | - Ji Hyun Shin
- Department of Pathology, University of California, San Diego, CA, 92093, USA
| | - Emily S Lukacz
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Diego, 92093, USA
| | - Linda Brubaker
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Diego, 92093, USA
| | - Leila K Schwanemann
- Department of Pathology, University of California, San Diego, CA, 92093, USA
| | - Rob Knight
- Departments of Pediatrics, Bioengineering, and Computer Science and Engineering, University of California, San Diego, 92093, USA
| | - Alan J Wolfe
- Department of Microbiology and Immunology, Loyola University Chicago, Maywood, IL, 601534, USA
| | - David T Pride
- Department of Pathology, University of California, San Diego, CA, 92093, USA.
- Department of Medicine, University of California, San Diego, CA, 92093, USA.
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21
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Abstract
Many studies have shown that the urinary tract harbours its own microbial community known as the urinary microbiota, which have been implicated in urinary tract disorders. This observation contradicts the long-held notion that urine is a sterile biofluid in the absence of acute infection of the urinary tract. In light of this new discovery, many basic questions that are crucial for understanding the role of the urinary microbiota in human health and disease remain unanswered. Given that the urinary microbiota is an emerging area of study, optimized techniques and protocols to identify microorganisms in the urinary tract are still being established. However, the low microbial biomass and close proximity to higher microbial biomass environments (for example, the vagina) present distinct methodological challenges for microbial community profiling of the urinary microbiota. A clear understanding of the unique technical considerations for obtaining and analysing low microbial biomass samples, as well the influence of key elements of experimental design and computational analysis on downstream interpretation, will improve our ability to interpret and compare results across methods and studies and is relevant for studies profiling the urinary microbiota and other sites of low microbial abundance.
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22
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Krakhotkin DV, Chernylovskyi VA, Bakurov EE, Sperl J. Evaluation of influence of the UPOINT-guided multimodal therapy in men with chronic prostatitis/chronic pelvic pain syndrome on dynamic values NIH-CPSI: a prospective, controlled, comparative study. Ther Adv Urol 2019; 11:1756287219857271. [PMID: 31263510 PMCID: PMC6595637 DOI: 10.1177/1756287219857271] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 05/26/2019] [Indexed: 12/15/2022] Open
Abstract
Background: The aim of this work was to evaluate the influence of UPOINT-guided (Urinary, Psychosocial, Organ-specific, Infection, Neurologic/systemic, Tenderness of skeletal muscles) multimodal therapy in patients with chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS) on the dynamic values of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score. Patients and methods: In our study we investigated 110 patients aged 26–68 years with CP/CPPS. We performed digital rectal examination (DRE), pre- and post-massage test (PPMT) urine culture, urine analysis, transrectal ultrasound investigation of prostate, antibiotic susceptibility testing. We divided the patients into the intervention group and the control group which was followed up without any therapy. For the intervention group we offered multimodal therapy based on each predominated positive phenotype. For the urinary phenotype, patients in intervention group received 10 mg alfuzosin. For organ-specific and tenderness domains, the patients of the intervention group received 63 mg Cernilton and 1 g Quercetin. For infection control, the patients of the intervention group received antimicrobial agents according to the results of the post-massage urine culture, antibiotic susceptibility testing and a high level of contamination >105 colony-forming units (CFU)/ml. Microbiological assessment of PPMT urine culture was conducted with aerobic and anaerobic methods of cultivation Results: The 110 patients had an average age of 43.9 ± 11.1 years and a median duration of symptoms of 6.21 ± 1.8 months. Of these, 11 patients did not complete the trial and therefore in quantitative terms, the distribution of patients was as follows: 54 in the intervention group and 45 in the control group. The average total NIH-CPSI score before treatment was 29.8 ± 6.1 in both groups. The mean NIH-CPSI of the pain, urinary, and quality of life (QOL) subscores before treatment was 15.1 ± 3.0, 7.4 ± 1.4 and 8.1 ± 2.1, respectively in both groups. After 6 weeks the PPMT urine culture of patients of the intervention group showed the absence or low-level contamination of microorganisms. After conducting the treatment, the mean total NIH-CPSI score in the intervention and control groups was 13.9 ± 2.8 (p = 0.025) and 29.8 ± 5.8 (p = 0.18), respectively. The average NIH-CPSI pain subscore in the intervention and control group after treatment was 6.7 ± 1.4 (p = 0.018) and 15.1 ± 2.8 (p = 0.21), respectively. The mean NIH-CPSI urinary subscore after treatment in the intervention and control group was 3.22 ± 1.07 (p = 0.045) and 7.4 ± 1.2 (p = 0.15), respectively. The average NIH-CPSI QOL subscore after treatment in the intervention and control group was 3.87 ± 1.28 (p = 0.015) and 8.1 ± 1.9 (p = 0.35). After multimodal therapy, the prevalence of different UPOINT-positive domains in the patients of both intervention groups did not exceed 14%. Conclusions: The UPOINT clinical phenotypes significantly changed after multimodal treatment, including antibiotics, phytotherapy and α-blockers in patients with CP/CPPS. This combination of treatment showed a decreasing total NIH-CPSI score and an elevation of QOL in patients.
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Affiliation(s)
- Denis V Krakhotkin
- Central District Hospital, Outpatient Clinic, Sadovaya Lane 23, Kamenolomni, 346480, Rostov Region, Russia
| | | | - Evgeny E Bakurov
- Rostov Regional Hospital ROKB 1, Department of Surgery №1, Rostov-on-Don, Russia
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23
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Grine G, Lotte R, Chirio D, Chevalier A, Raoult D, Drancourt M, Ruimy R. Co-culture of Methanobrevibacter smithii with enterobacteria during urinary infection. EBioMedicine 2019; 43:333-337. [PMID: 31072770 PMCID: PMC6558020 DOI: 10.1016/j.ebiom.2019.04.037] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/10/2019] [Accepted: 04/18/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Urinary tract infections are known to be caused by bacteria, but the potential implications of archaea have never been studied in this context. METHODS In two different university hospital centres we used specific laboratory methods for the detection and culture of archaeal methanogens in 383 urine specimens prospectively collected for diagnosing urinary tract infection (UTI). FINDINGS Methanobrevibacter smithii was detected by quantitative PCR and sequencing in 34 (9%) of the specimens collected from 34 patients. Escherichia coli, Klebsiella pneumoniae, Enterobacter sp., Enterococcus faecium and mixed cultures were detected along with M. smithii in eighteen, six, three, one and six urine samples, respectively. Interestingly, using our specific culture method for methanogens, we also isolated M. smithii in 31 (91%) of the 34 PCR positive urine samples. Genotyping the 31 isolates using multispacer sequence typing revealed three different genotypes which have been previously reported in intestinal microbiota. Antibiotic susceptibility testing found the 31 isolates to be in vitro susceptible to metronidazole (MIC: 1 mg/L) but resistant to fosfomycin, sulfamethoxazole-trimethoprim, amoxicillin-clavulanate and ofloxacin, commonly used to treat bacterial UTI. Finally, 19 (54%) of the 34 patients in whose urine samples M. smithii was detected were diagnosed with UTIs, including cystitis, pyelonephritis and prostatitis. INTERPRETATION Our results show that M. smithii is part of the urinary microbiota of some individuals and could play a role in community-acquired UTI in association with enteric bacteria. FUND: This study was supported by IHU Méditerranée Infection, Marseille, France.
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Affiliation(s)
- Ghiles Grine
- IHU Méditerranée Infection, Marseille, France; Aix Marseille Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France; Laboratoire de bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet II, Nice, France
| | - Romain Lotte
- Laboratoire de bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet II, Nice, France; Université Côte d'Azur, Inserm, C3M, Nice, France; Inserm U1065, C3M, Equipe 6 « Virulence microbienne et signalisation inflammatoire », Bâtiment universitaire Archimède, Nice, France
| | - David Chirio
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet I, Nice, France
| | - Alicia Chevalier
- Laboratoire de bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet II, Nice, France
| | - Didier Raoult
- Aix Marseille Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Michel Drancourt
- Aix Marseille Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Raymond Ruimy
- Laboratoire de bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet II, Nice, France; Université Côte d'Azur, Inserm, C3M, Nice, France; Inserm U1065, C3M, Equipe 6 « Virulence microbienne et signalisation inflammatoire », Bâtiment universitaire Archimède, Nice, France.
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Ackerman AL, Anger JT, Khalique MU, Ackerman JE, Tang J, Kim J, Underhill DM, Freeman MR. Optimization of DNA extraction from human urinary samples for mycobiome community profiling. PLoS One 2019; 14:e0210306. [PMID: 31022216 PMCID: PMC6483181 DOI: 10.1371/journal.pone.0210306] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/15/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Recent data suggest the urinary tract hosts a microbial community of varying composition, even in the absence of infection. Culture-independent methodologies, such as next-generation sequencing of conserved ribosomal DNA sequences, provide an expansive look at these communities, identifying both common commensals and fastidious organisms. A fundamental challenge has been the isolation of DNA representative of the entire resident microbial community, including fungi. MATERIALS AND METHODS We evaluated multiple modifications of commonly-used DNA extraction procedures using standardized male and female urine samples, comparing resulting overall, fungal and bacterial DNA yields by quantitative PCR. After identifying protocol modifications that increased DNA yields (lyticase/lysozyme digestion, bead beating, boil/freeze cycles, proteinase K treatment, and carrier DNA use), all modifications were combined for systematic confirmation of optimal protocol conditions. This optimized protocol was tested against commercially available methodologies to compare overall and microbial DNA yields, community representation and diversity by next-generation sequencing (NGS). RESULTS Overall and fungal-specific DNA yields from standardized urine samples demonstrated that microbial abundances differed significantly among the eight methods used. Methodologies that included multiple disruption steps, including enzymatic, mechanical, and thermal disruption and proteinase digestion, particularly in combination with small volume processing and pooling steps, provided more comprehensive representation of the range of bacterial and fungal species. Concentration of larger volume urine specimens at low speed centrifugation proved highly effective, increasing resulting DNA levels and providing greater microbial representation and diversity. CONCLUSIONS Alterations in the methodology of urine storage, preparation, and DNA processing improve microbial community profiling using culture-independent sequencing methods. Our optimized protocol for DNA extraction from urine samples provided improved fungal community representation. Use of this technique resulted in equivalent representation of the bacterial populations as well, making this a useful technique for the concurrent evaluation of bacterial and fungal populations by NGS.
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Affiliation(s)
- A. Lenore Ackerman
- Department of Surgery, Division of Urology, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
| | - Jennifer Tash Anger
- Department of Surgery, Division of Urology, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
| | - Muhammad Umair Khalique
- Department of Surgery, Division of Urology, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
| | - James E. Ackerman
- Department of Surgery, Division of Urology, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
| | - Jie Tang
- Department of Biomedical Sciences, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
| | - Jayoung Kim
- Department of Surgery, Division of Urology, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
- Department of Biomedical Sciences, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
| | - David M. Underhill
- Department of Biomedical Sciences, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
- Department of Medicine, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
| | - Michael R. Freeman
- Department of Surgery, Division of Urology, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
- Department of Biomedical Sciences, Cedars−Sinai Medical Center, Los Angeles, CA, United States of America
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Buhmann MT, Abt D, Nolte O, Neu TR, Strempel S, Albrich WC, Betschart P, Zumstein V, Neels A, Maniura-Weber K, Ren Q. Encrustations on ureteral stents from patients without urinary tract infection reveal distinct urotypes and a low bacterial load. MICROBIOME 2019; 7:60. [PMID: 30981280 PMCID: PMC6462311 DOI: 10.1186/s40168-019-0674-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 03/28/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Current knowledge of the urinary tract microbiome is limited to urine analysis and analysis of biofilms formed on Foley catheters. Bacterial biofilms on ureteral stents have rarely been investigated, and no cultivation-independent data are available on the microbiome of the encrustations on the stents. RESULTS The typical encrustations of organic and inorganic urine-derived material, including microbial biofilms formed during 3-6 weeks on ureteral stents in patients treated for kidney and ureteral stones, and without reported urinary tract infection at the time of stent insertion, were analysed. Next-generation sequencing of the 16S rRNA gene V3-V4 region revealed presence of different urotypes, distinct bacterial communities. Analysis of bacterial load was performed by combining quantification of 16S rRNA gene copy numbers by qPCR with microscopy and cultivation-dependent analysis methods, which revealed that ureteral stent biofilms mostly contain low numbers of bacteria. Fluorescence microscopy indicates the presence of extracellular DNA. Bacteria identified in biofilms by microscopy had mostly morphogenic similarities to gram-positive bacteria, in few cases to Lactobacillus and Corynebacterium, while sequencing showed many additional bacterial genera. Weddellite crystals were absent in biofilms of patients with Enterobacterales and Corynebacterium-dominated microbiomes. CONCLUSIONS This study provides novel insights into the bacterial burden in ureteral stent encrustations and the urinary tract microbiome. Short-term (3-6 weeks) ureteral stenting is associated with a low load of viable and visible bacteria in ureteral stent encrustations, which may be different from long-term stenting. Patients could be classified according to different urotypes, some of which were dominated by potentially pathogenic species. Facultative pathogens however appear to be a common feature in patients without clinically manifested urinary tract infection. TRIAL REGISTRATION ClinicalTrials.gov, NCT02845726 . Registered on 30 June 2016-retrospectively registered.
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Affiliation(s)
- Matthias T. Buhmann
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Dominik Abt
- Department of Urology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland
| | - Oliver Nolte
- Zentrum für Labormedizin, Frohbergstrasse 3, 9001 St. Gallen, Switzerland
| | - Thomas R. Neu
- Microbiology of Interfaces, Department River Ecology, Helmholtz Centre for Environmental Research – UFZ, Brueckstrasse 3A, 39114 Magdeburg, Germany
| | | | - Werner C. Albrich
- Division of Infectious Diseases/Hospital Epidemiology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland
| | - Patrick Betschart
- Department of Urology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland
| | - Valentin Zumstein
- Department of Urology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland
| | - Antonia Neels
- Center for X-ray Analytics, Empa, Überlandstrasse 129, 8600 Dübendorf, Switzerland
| | - Katharina Maniura-Weber
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Qun Ren
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
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The Microbiome and Genitourinary Cancer: A Collaborative Review. Eur Urol 2019; 75:637-646. [PMID: 30655087 PMCID: PMC9774685 DOI: 10.1016/j.eururo.2018.12.043] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/21/2018] [Indexed: 12/24/2022]
Abstract
CONTEXT The recent discovery of the existence of a human genitourinary microbiome has led to the investigation of its role in mediating the pathogenesis of genitourinary malignancies, including bladder, kidney, and prostate cancers. Furthermore, although it is largely recognized that members of the gastrointestinal microbiota are actively involved in drug metabolism, new studies demonstrate additional roles and the potential necessity of the gastrointestinal microbiota in dictating cancer treatment response. OBJECTIVE To summarize the current evidence of a mechanistic role for the genitourinary and gastrointestinal microbiome in genitourinary cancer initiation and treatment response. EVIDENCE ACQUISITION We conducted a literature search up to October 2018. Search terms included microbiome, microbiota, urinary microbiome, bladder cancer, urothelial carcinoma, renal cell carcinoma, kidney cancer, testicular cancer, and prostate cancer. EVIDENCE SYNTHESIS There is preliminary evidence to implicate the members of the genitourinary microbiota as causative factors or cofactors in genitourinary malignancy. Likewise, the current evidence for gastrointestinal microbes in dictating cancer treatment response is mainly correlative; however, we provide examples where therapeutic agents used for the treatment of genitourinary cancers are affected by the human-associated microbiota, or vice versa. Clinical trials, such as fecal microbiota transplant to increase the efficacy of immunotherapy, are currently underway. CONCLUSIONS The role of the microbiome in genitourinary cancer is an emerging field that merits further studies. Translating microbiome research into clinical action will require incorporation of microbiome surveillance into ongoing and future clinical trials as well as expansion of studies to include metagenomic sequencing and metabolomics. PATIENT SUMMARY This review covers recent evidence that microbial populations that reside in the genitourinary tract-and were previously not known to exist-may influence the development of genitourinary malignancies including bladder, kidney, and prostate cancers. Furthermore, microbial populations that exist at sites outside of the genitourinary tract, such as those that reside in our gut, may influence cancer development and/or treatment response.
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Baldissera-Aradas J, Rodríguez-Villamil L, Blanco-Fernández R, Pérez-García C, Viejo de la guerra G, González-Rodríguez I, Mosquera-Madera J. Rectal culture-directed antibiotic prophylaxis before transrectal prostate biopsy: Reduced infectious complications and healthcare costs. Actas Urol Esp 2018; 42:465-472. [PMID: 29331324 DOI: 10.1016/j.acuro.2017.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/29/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Transrectal ultrasound-guided prostate biopsy (TUPB) is associated with infectious complications (ICs), which are related to a greater prevalence of ciprofloxacin-resistant bacteria (CRB) in rectal flora. We examined the ICs that occurred in 2 groups: A guided antibiotic prophylaxis (GP) group and an empiric prophylaxis (EP) group. We assessed the financial impact of GP. MATERIAL AND METHODS The GP group was studied prospectively (June 2013 to July 2014). We collected rectal cultures (RCs) before the TUPB, which were seeded on selective media with ciprofloxacin to determine the presence of CRB. The patients with sensitive bacteria were administered ciprofloxacin. Patients with resistant bacteria were administered GP according to the RC antibiogram. The EP group was studied retrospectively (January 2011 to June 2009). RCs were not performed, and all patients were treated with ciprofloxacin as prophylaxis. The ICs in both groups were recorded during a period no longer than 30 days following TUPB (electronic medical history). RESULTS Three hundred patients underwent TUPB, 145 underwent GP, and 155 underwent EP. In the GP group, 23 patients (15.86%) presented CRB in the RCs. Only one patient (0.7%) experienced a UTI. In the EP group, 26 patients (16.8%) experienced multiple ICs (including 2 cases of sepsis) (P<.005). The estimated total cost, including the management of the ICs, was €57,076 with EP versus €4802.33 with GP. The average cost per patient with EP was €368.23 versus €33.11 with GP. GP achieved an estimated total savings of €52,273.67. Six patients had to undergo GP to prevent an IC. CONCLUSIONS GP is associated with a marked decrease in the incidence of ICs caused by CRB and reduced healthcare costs.
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28
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Poch M, Hall M, Joerger A, Kodumudi K, Beatty M, Innamarato PP, Bunch BL, Fishman MN, Zhang J, Sexton WJ, Pow-Sang JM, Gilbert SM, Spiess PE, Dhillon J, Kelley L, Mullinax J, Sarnaik AA, Pilon-Thomas S. Expansion of tumor infiltrating lymphocytes (TIL) from bladder cancer. Oncoimmunology 2018; 7:e1476816. [PMID: 30228944 PMCID: PMC6140546 DOI: 10.1080/2162402x.2018.1476816] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 12/23/2022] Open
Abstract
Advanced bladder cancer patients have limited therapeutic options resulting in a median overall survival (OS) between 12 and 15 months. Adoptive cell therapy (ACT) using tumor infiltrating lymphocytes (TIL) has been used successfully in treating patients with metastatic melanoma, resulting in a median OS of 52 months. In this study, we investigated the feasibility of expanding TIL from the tumors of bladder cancer patients. Primary bladder tumors and lymph node (LN) metastases were collected. Tumor specimens were minced into fragments, placed in individual wells of a 24-well plate, and propagated in high dose IL-2 for four weeks. Expanded TIL were phenotyped by flow cytometry and anti-tumor reactivity was assessed after co-culture with autologous tumor digest and IFN-gamma ELISA. Of the 28 transitional cell bladder or LN tumors collected, 14/20 (70%) primary tumors and all of the LN metastases demonstrated TIL expansion. Expanded TIL were predominantly CD3+ (median 63%, range 10-87%) with a median of 30% CD8 + T cells (range 5-70%). TIL secreted IFN-gamma in response to autologous tumor. Addition of agonisitic 4-1BB antibody improved TIL expansion from primary bladder tumors regardless of pre-treatment with chemotherapy. This study establishes the practical first step towards an autologous TIL therapy process for therapeutic testing in patients with bladder cancer.
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Affiliation(s)
- Michael Poch
- Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - MacLean Hall
- Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Autumn Joerger
- Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Krithika Kodumudi
- Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Matthew Beatty
- Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | | | - Brittany L Bunch
- Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Mayer N Fishman
- Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Jingsong Zhang
- Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Wade J Sexton
- Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Julio M Pow-Sang
- Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Scott M Gilbert
- Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Jasreman Dhillon
- Pathology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Linda Kelley
- Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA.,Cell Therapies, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - John Mullinax
- Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA.,Sarcoma, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Amod A Sarnaik
- Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA.,Cutaneous Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Shari Pilon-Thomas
- Department of Genitourinary Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA.,Immunology, Moffitt Cancer Center and Research Institute, Tampa, USA.,Cutaneous Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA
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May D, Togami JM. Urologic Applications of the Microbiota in Multiple Sclerosis. CURRENT BLADDER DYSFUNCTION REPORTS 2018. [DOI: 10.1007/s11884-018-0461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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