Urethral microbiome and non-gonococcal urethritis in men who have sex with men (M

摘要 高达50%的尿道炎病例，最常见的男性生殖道综合征，没有已知的病因。 微生物群的不平衡（生态失调）越来越多地被认为是临床发展的因素。 综合征，并可能导致尿道炎。在异性恋男性中，Leptotrichia/Sneathia属，显著 与特发性非淋菌性尿道炎（NGU）相关，NGU患者的尿道 微生物群落（例如，物种多样性较低，惰性乳杆菌丰度较高， Gardnerella vagularis比没有NGU的男性更容易感染，这表明微生物群可能在NGU中起因果作用。 尿道炎的发展。然而，在异性恋男性中， 与女性生殖道感染有关，并且可能在性伴侣之间共享。男男性行为者 男男性行为者（MSM），在许多情况下占NGU病例的一半，很少（如果有的话）接触到 阴道微生物群我们假设男性尿道微生物群反映了暴露的解剖部位 MSM中与NGU相关的生态失调的性质与异性恋男性不同。为了验证这个，我们 将使用宽范围的16 S rRNA基因PCR和高通量测序来（a）确定尿道如何 MSM中表征NGU的微生物群不同于异性恋男性中的微生物群;（B）确定是否 特定的微生物群落与标准治疗后MSM中NGU的持续性和复发相关。 抗生素治疗;以及（c）探索特定性行为对男性尿道微生物群的影响 和NGU复发。这些研究将提高NGU的临床管理， 性传播感染和艾滋病毒的风险，并可能导致新的预防策略和/或临床试验 新的治疗方法，以消除关键的细菌物种或恢复正常的细菌。

ABSTRACT Up to 50% of urethritis cases, the most common male reproductive tract syndrome, have no known etiology. Imbalances in the microbiota (dysbiosis) are increasingly recognized as factors in the development of clinical syndromes and may cause urethritis. In heterosexual men, Leptotrichia/Sneathia spp., were significantly associated with idiopathic non-gonococcal urethritis (NGU) and men with NGU had distinctive urethral microbial communities (e.g., lower species diversity and higher abundance of Lactobacillis iners and Gardnerella vaginalis than men without NGU), suggesting that the microbiota may play a causal role in the development of urethritis. However, the bacteria that characterized NGU in heterosexual men have been associated with female reproductive tract infection and are likely shared between sex partners. Men who have sex with men (MSM), who comprise half of NGU cases in many settings, rarely, if ever, have exposures to the vaginal microbiota. We hypothesize that the male urethral microbiota reflects the anatomic sites of exposure and that the nature of dysbiosis associated with NGU in MSM differs from heterosexual men. To test this, we will use broad range 16S rRNA gene PCR with high-throughput sequencing to (a) determine how the urethral microbiota that characterizes NGU in MSM differs from that in heterosexual men; (b) determine whether specific microbial communities are associated with persistence and recurrence of NGU in MSM after standard antibiotic therapy; and (c) explore the influence of specific sexual behaviors on the male urethral microbiota and recurrence of NGU. These studies will enhance the clinical management of NGU in the group at highest risk of sexually transmitted infection and HIV, and may lead to novel prevention strategies and/or clinical trials of new therapies to eradicate key bacterial species or restore normal bacteria.