Temporal dynamics of certain human microbiotas have been described in longitudinal studies; variability often relates to modifiable factors or behaviors. Early studies of the urinary microbiota preferentially used samples obtained by transurethral catheterization to minimize vulvovaginal microbial contributions. Whereas voided specimens are preferred for longitudinal studies, the few studies that reported longitudinal data were limited to women with lower urinary tract (LUT) symptoms, due to ease of accessing a clinical population for sampling and the impracticality and risk of collecting repeated catheterized urine specimens in a nonclinical population. Here, we studied the microbiota of the LUT of nonsymptomatic, premenopausal women using midstream voided urine (MSU) specimens to investigate relationships between microbial dynamics and personal factors. Using 16S rRNA gene sequencing and a metaculturomics method called expanded quantitative urine culture (EQUC), we characterized the microbiotas of MSU and periurethral swab specimens collected daily for approximately 3 months from a small cohort of adult women. Participants were screened for eligibility, including the ability to self-collect paired urogenital specimens prior to enrollment. In this population, we found that measures of microbial dynamics related to specific participant-reported factors, particularly menstruation and vaginal intercourse. Further investigation of the trends revealed differences in the composition and diversity of LUT microbiotas within and across participants. These data, in combination with previous studies showing relationships between the LUT microbiota and LUT symptoms, suggest that personal factors relating to the genitourinary system may be an important consideration in the etiology, prevention, and/or treatment of LUT disorders. IMPORTANCE Following the discovery of the collective human urinary microbiota, important knowledge gaps remain, including the stability and variability of this microbial niche over time. Initial urinary studies preferentially utilized samples obtained by transurethral catheterization to minimize contributions from vulvovaginal microbes. However, catheterization has the potential to alter the urinary microbiota; therefore, voided specimens are preferred for longitudinal studies. In this report, we describe microbial findings obtained by daily assessment over 3 months in a small cohort of adult women. We found that, similarly to vaginal microbiotas, lower urinary tract (LUT) microbiotas are dynamic, with changes relating to several factors, particularly menstruation and vaginal intercourse. Our study results show that LUT microbiotas are both dynamic and resilient. They also offer novel opportunities to target LUT microbiotas by preventative or therapeutic means, through risk and/or protective factor modification.
245/250) 24MANUSCRIPT: (5000/5000) 25 ACKNOWLEDGMENTS: We thank Mary Tulke RN for her assistance with participant 35 recruitment. We also acknowledge funding from NIH (R01 DK104718 awarded to AJW 36and LB). The funders did not play a part in the design or conduct of the study. 37 TKP, BW, LB, ERM, and AJW designed the study. TKP and BW recruited participants. 38TKP processed the specimens. TH prepared them for DNA sequencing. RL sequenced 39 the specimens. TKP, BW, QD and AJW analyzed the data. TKP and AJW wrote the 40 manuscript. TKP, BW, TH, RL, LB, QD, ERM, and AJW reviewed and edited the 41 manuscript. 42 43 ABSTRACT 59Temporal dynamics of certain human microbiotas have been described in 60 longitudinal studies; variability often relates to modifiable factors or behaviors. Early 61 studies of the urinary microbiota preferentially used samples obtained by transurethral 62 catheterization to minimize vulvo-vaginal microbial contributions. Whereas voided 63 specimens are preferred for longitudinal studies, the few studies that reported 64 longitudinal data were limited to women with lower urinary tract (LUT) symptoms, due to 65 ease of accessing a clinical population for sampling and the impracticality and risk of 66 collecting repeated catheterized urine specimens in a non-clinical population. Here, we 67 studied the microbiota of the LUT of non-symptomatic, pre-menopausal women using 68 mid-stream voided urine (MSU) specimens to investigate relationships between 69 microbial dynamics and personal factors. Using 16S rRNA gene sequencing and a 70 metaculturomics method called Expanded Quantitative Urine Culture (EQUC), we 71 characterized the microbiotas of MSU and peri-urethral swab specimens collected daily 72 for approximately three months from a small cohort of adult women. Participants were 73 screened for eligibility, including ability to self-collect paired urogenital specimens prior 74 to enrollment. In this population, we found that measures of microbial dynamics related 75 to specific participant-reported factors, particularly menstruation and vaginal 76intercourse. Further investigation of the trends revealed differences in composition and 77 diversity of LUT microbiotas within and across participants. These data, in combination 78 with previous studies showing relationships between the LUT microbiota and LUT 79 symptoms, suggest that personal factors relating to the genitourinary system may be an 80 important consideration in the etiology, prevention, and/or treatment of LUT disorders.
Introduction-Previous work has shown that the vaginal microbiome decreases in Lactobacilluspredominance and becomes more diverse following menopause. It has also been shown that estrogen therapy restores Lactobacillus-dominance in the vagina, and that topical estrogen is associated with OAB symptom improvement. We now know that the bladder contains a unique microbiome, and increased bladder microbiome diversity is associated with OAB. However, there is no understanding of how quickly each pelvic floor microbiome responds to estrogen or if those changes are associated with symptom improvement.Study Design-Analysis of data from post-menopausal participants in two trials (NCT02524769 and NCT02835846) who chose vaginal estrogen as their primary OAB treatment and used 0.5 grams of conjugated estrogen (Premarin Cream, (Pfizer, New York City, NY)) twice weekly for 12 weeks. Baseline and 12-week follow-up data included the OAB-q questionnaire and participants provided catheterized urine, vaginal swabs, perineal swabs, and voided urine. Microbes were detected by an enhanced culture protocol. Linear mixed models were used to estimate microbiome changes over time. Urinary AMP activity was assessed by a bacterial growth inhibition assay and correlated with relative abundance of members of the urobiome.Results-Twelve weeks of estrogen treatment resulted in decreased microbial diversity within the vagina (Shannon, p=0.047; Richness, p=0.043), but not in the other niches. A significant increase in Lactobacillus was detected in the bladder (p=0.037), but not the vagina (p=0.33), perineum (p=0.56), or voided urine (p=0.28). The change in Lactobacillus levels in the bladder was associated with modest changes in urgency incontinence symptoms (p=0.02). The relative abundance of the genus Corynebacterium correlated positively with urinary AMP activity after estrogen treatment. Conclusion-Estrogentherapy may change the microbiome of different pelvic floor niches. The vagina begins to decrease in diversity and the bladder experiences a significant increase in Lactobacillus levels; the latter is correlated with a modest improvement in the symptom severity sub-scale of the OAB-q. CondensationEstrogen therapy for overactive bladder resulted in decreased bladder bacterial diversity and increased bladder Lactobacillus, which were associated with modest changes in urgency incontinence symptoms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.