Urinary Microbiome and Cytokine Levels in Women With Interstitial Cystitis
Urinary Microbiome and Cytokine Levels in Women With Interstitial Cystitis
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DOI：
10.1097/aog.0000000000001892
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发表时间：
2017-03-01
影响因子：
7.2
通讯作者：
Kenton, Kimberly
中科院分区：
文献类型：
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作者：
Abernethy, Melinda G.;Rosenfeld, Amy;Kenton, Kimberly
目的：调查患有和没有间质性膀胱炎的女性之间尿液微生物组和细胞因子水平的差异，并将差异与标准化症状严重程度量表以及抑郁和焦虑筛查工具的评分相关联。方法：我们的横断面研究比较了在6个月内前往盆底诊所并被诊断患有间质性膀胱炎的女性与来自同一机构的年龄匹配的对照组女性。参与者提供了导尿管尿液样本，并完成了症状严重程度，生活质量，抑郁和焦虑筛查问卷。使用标准免疫测定法分析通过细菌核糖体RNA测序产生的尿液微生物组和细胞因子水平。非参数分析用于所有comparation.RESULTS：间质性膀胱炎的参与者报告更多的残疾，麻烦的泌尿系统症状，泌尿生殖系统疼痛，性功能障碍和得分较高的抑郁症和焦虑症的屏幕相比，在对照组的妇女。间质性膀胱炎参与者的尿液包含较少的不同操作分类单位（2 [中位数范围2-7，四分位数间距1]与3.5 [中位数，范围2-22，四分位数间距5.25]相比，P= 0.015），并且不太可能含有嗜酸乳杆菌（114 [7%]与718 [39%]相比，P= 0.05）与对照组的女性相比。嗜酸乳杆菌与间质性膀胱炎症状指数评分较低相关（1 [中位数，范围0-17，四分位距5]与10 [中位数，范围0-14，四分位距11]相比，P=.005）和泌尿生殖道疼痛指数（0 [中位数，范围0-42，四分位距22]与22.5 [中位数，范围0-40，四分位距28]相比，P= 0.03）。间质性膀胱炎的参与者表现出更高水平的巨噬细胞源性趋化因子（13.32 [中位数，范围8.93-17.05，四分位距15.86]与0 [中位数，范围8.93-22.67，四分位距10.35]相比，P= 0.037）和白细胞介素-4（1.95 [中位数，范围1.31-997，四分位距11.84]与1.17 [中位数，范围0.44-3.26，四分位距1.51]相比，P= 0.029）。白细胞介素-4与间质性膀胱炎症状指数的严重程度呈正相关（r=0.406，P= 0.013）。间质性膀胱炎的参与者的尿微生物组的多样性较低，不太可能含有乳酸杆菌属物种，并与较高水平的促炎细胞因子。目前尚不清楚这是否代表因果关系，以及尿液微生物组改变的影响是否通过炎症反应介导。
OBJECTIVE: To investigate differences in the urinary microbiome and cytokine levels between women with and without interstitial cystitis and to correlate differences with scores on standardized symptom severity scales and depression and anxiety screening tools.METHODS: Our cross-sectional study compared women presenting to a pelvic floor clinic and diagnosed with interstitial cystitis over a 6-month period with age-matched women in a control group from the same institution. Participants provided a catheterized urine sample and completed symptom severity, quality-of-life, depression, and anxiety screening questionnaires. Urinary microbiomes generated through bacterial ribosomal RNA sequencing and cytokine levels were analyzed using a standard immunoassay. Nonparametric analyses were used for all comparisons.RESULTS: Participants with interstitial cystitis reported more disability, bothersome urinary symptoms, genitourinary pain, and sexual dysfunction and scored higher on depression and anxiety screens compared with women in the control group. The urine of participants with interstitial cystitis contained fewer distinct operational taxonomic units (2 [median range 2-7, interquartile range 1] compared with 3.5 [median, range 2-22, interquartile range 5.25], P=.015) and was less likely to contain Lactobacillus acidophilus (114 [7%] compared with 718 [39%], P=.05) compared with women in the control group. L acidophilus was associated with less severe scores on the Interstitial Cystitis Symptoms Index (1 [median, range 0-17, interquartile range 5] compared with 10 [median, range 0-14, interquartile range 11], P=.005) and the Genitourinary Pain Index (0 [median, range 0-42, interquartile range 22] compared with 22.5 [median, range 0-40, interquartile range 28], P=.03). Participants with interstitial cystitis demonstrated higher levels of macrophage-derived chemokine (13.32 [median, range 8.93-17.05, interquartile range 15.86] compared with 0 [median, range 8.93-22.67, interquartile range 10.35], P=.037) and interleukin-4 (1.95 [median, range 1.31-997, interquartile range 11.84] compared with 1.17 [median, range 0.44-3.26, interquartile range 1.51], P=.029). There was a positive correlation between interleukin-4 and more severe scores on the Interstitial Cystitis Symptoms Index (r=0.406, P=.013). No associations between the presence of lactobacillus species and cytokine levels were observed.CONCLUSION: The urinary microbiome of participants with interstitial cystitis was less diverse, less likely to contain Lactobacillus species, and associated with higher levels of proinflammatory cytokines. It is unknown whether this represents causality and whether the effect of alterations to the urinary microbiome is mediated through an inflammatory response.