Pro: The urinary microbiome is a potential driver of urinary tract pathology through multiple mechanisms including deglucuronidation and DNA damage
File(s)
Accepted version
Author(s)
Marchesi, Julian
Drake, Marcus
Type
Journal Article
Abstract
Changes in the urinary microbiome have been reported in urinary tract conditions such as overactive bladder syndrome and bladder pain syndrome (BPS). Potentially, chronic infection or colonisation of the urinary tract involves processes which help a bacterium to survive in this challenging environment, with harmful implications for the host. For example, E. coli strains in the bladder expressing beta-glucuronidases may remove glucuronides from molecules in the urine to use as a food source. Conceivably, this could reactivate toxins and carcinogens which the body had detoxified by glucuronidation, with potential harmful effects on the urothelium. A microbiome could also contribute to pathology by causing DNA damage, for example via colibactin, hence potentially initiating cancer. A bacterial enzyme capable of extracting carbohydrate from the glycosaminoglycan (GAG) layer would provide nutrient for the bacterium, but could impair urothelial host defences, which may predispose to UTI or BPS. Hence, bacteria, and perhaps other organisms in the microbiome, may drive urinary tract disease. However, care is needed to ensure a scrupulous approach to investigating these hypothetical possibilities, with robust and credible scientific methodologies.
Date Acceptance
2024-08-19
Citation
European Urology Focus
ISSN
2405-4569
Publisher
Elsevier
Journal / Book Title
European Urology Focus
Copyright Statement
Subject to copyright. This paper is embargoed until publication. Once published the author’s accepted manuscript will be made available under a CC-BY License in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy).
License URL
Publication Status
Accepted
Rights Embargo Date
10000-01-01