Intestinal Permeability and Dysbiosis in Female Patients with Recurrent Cystitis: A Pilot Study

Abstract

Recurrent cystitis (RC) is a common disease, especially in females. Anatomical, behavioral and genetic predisposing factors are associated with the ascending retrograde route, which often causes bladder infections. RC seems to be mainly caused by agents derived from the intestinal microbiota, and most frequently by Escherichia coli. Intestinal contiguity contributes to the etiopathogenesis of RC and an alteration in intestinal permeability could have a major role in RC. The aim of this pilot study is to assess gut microbiome dysbiosis and intestinal permeability in female patients with RC. Patients with RC (n = 16) were enrolled and compared with healthy female subjects (n = 15) and patients with chronic gastrointestinal (GI) disorders (n = 238). We calculated the Acute Cystitis Symptom Score/Urinary Tract Infection Symptom Assessment (ACSS/UTISA) and Gastrointestinal Symptom Rating Scale (GSRS) scores and evaluated intestinal permeability and the fecal microbiome in the first two cohorts. Patients with RC showed an increased prevalence of gastrointestinal symptoms compared with healthy controls. Of the patients with RC, 88% showed an increased intestinal permeability with reduced biodiversity of gut microbiota compared to healthy controls, and 68% of the RC patients had a final diagnosis of gastrointestinal disease. Similarly, GI patients reported a higher incidence of urinary symptoms with a diagnosis of RC in 20%. Gut barrier impairment seems to play a major role in the pathogenesis of RC. Further studies are necessary to elucidate the role of microbiota and intestinal permeability in urinary tract infections.

Role of N-acetylkynurenine in mediating the effect of gut microbiota on urinary tract infection: a Mendelian randomization study

“…In our study, the genus Ruminococcaceae UCG010 , a member of the Ruminococcaceae family, emerged as a potential risk factor for UTI. Consistent with prior studies ( Worby et al, 2022b ), the abundance of Ruminococcaceae decreased in patients with recurrent UTI, suggesting that Ruminococcus could serve as a potential marker for dysbiosis in recurrent cystitis ( Graziani et al, 2022 ). The f_Ruminococcaceae is also known to be significantly affected by chronic infections ( Martinez et al, 2022 ; Tran et al, 2023 ) and the administration of antibiotics ( Ross et al, 2016 ).…”

The Possible Role of Probiotic Supplementation in Inflammation: A Narrative Review

“…In this regard, the intestine may act as a reservoir of uropathogens (“gut–bladder axis”), and thus, it plays an important role in UTI pathogenesis and the crosstalk between the intestinal and urogenital microbiome [ 80 ]. In addition, alterations in intestinal tight junctions in people with the “leaky gut syndrome” could represent another mechanism for visceral organ crosstalk, increasing the risk of bacterial material in the bladder, inflammation, and risk of UTIs [ 81 ]. In this context, probiotics can be used to alter bacterial colonization.…”

Disorders of intestinal microbiocenosis: expanding the application of probiotics

“…Синдром повышенной эпителиальной проницаемости (СПЭП) слизистой оболочки ЖКТ, в первую очередь кишечника, является одним из наиболее изучаемых патогенетических синдромов в ХХI в. [67][68][69][70]. В англоязычной литературе для его обозначения широко используется термин «the leaky gut syndrome» («синдром протекаю щей или дырявой кишки» [71].…”