An unbalanced microbiome may lead to disease by creating aberrant immune responses. A recent association of cellular rejection with the development of interstitial fibrosis and tubular atrophy (IFTA) suggests the role of immune-mediated tissue injury. We hypothesized that developing IFTA correlates with altered urinary tract microbiomes (UMBs).
UMBs at two serial time points, 1 and 6-8 months post-transplant, were assessed by 16S microbial ribosomal gene sequencing in 25 patients developing biopsy-proven IFTA compared to 23 transplant patients with normal biopsies and excellent function (TX) and 20 healthy non-transplant controls (HC).
Streptococcus, the dominant genera in HC males, was lower in IFTA and TX males at 1 month compared to HCs. At 6-8 months, Streptococcus was further decreased in IFTA males, but normalized in TX. IFTA males and females had increases in number of genera per sample at 6-8 months. UMB composition varied substantially between individuals in all groups.
Despite the wide variation in UMBs between individuals, IFTA associated with a loss in dominant resident urinary microbes in males, and a parallel increase in non-resident, pathogenic bacteria in males and females. UMB changes may contribute to IFTA development by alteration of the host immune response.
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