Современный взгляд на микробиом мочевыводящих путей
Ключевые слова:
микробиом мочевыводящих путей, здоровый микробиом, хронические инфекции мочевыводящих путей, коррекция микробиомов, кишечная микрофлора, синбиотики
Аннотация
В обзоре представлены последние данные о микробиоме мочевыводящих путей (МВП). Наличие резидентного микробиома МВП стало неожиданным открытием последних лет. Было обнаружено, что среди постоянных обитателей МВП преобладают медленно растущие трудно культивируемые виды, в том числе анаэробные бактерии. В связи с этим назрела насущная необходимость в пересмотре ряде аспектов общепринятых схем диагностики, картины патогенеза, терапевтических подходов в лечении инфекций мочевыводящих путей, ранее опиравшихся на представление о стерильности МВП. Разрабатывается концепция «здорового микробиома» МВП. Получила очередное подтверждение необходимость сопоставления микробиологических находок с клинической картиной заболеваний. Показано, что изменения в микробном сообществе кишечника напрямую влияют на микрофлору МВП. Поэтому одним из перспективных подходов терапии хронических инфекций мочевыводящих путей является создание сложных многокомпонентных синбиотиков, содержащих нормальных обитателей кишечного тракта и необходимые для их роста субстраты. Уже сейчас при комплексном лечении хронических инфекций мочевыводящих путей используют пробиотики, фекальную трансплантацию и специальные диеты. Лавинообразный рост числа работ по изучению микробиомов человека позволяет ожидать значительный прогресс в области практического применения результатов этих исследований в ближайшее время.
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Литература
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10. Brubaker L., Wolfe A.J. The female urinary microbiota, urinary health and common urinary disorders. Ann. Transl. Med. 2017;5(2):34. https://doi.org/10.21037/atm.2016.11.62
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12. Price T.K., Dune T., Hilt E.E., Thomas-White K.J., Kliethermes S., Brincat C., et al. The clinical urine culture: enhanced techniques improve detection of clinically relevant microorganisms. J. Clin. Microbiol. 2016;54(5):1216–1222. https://doi .org/10.1128/JCM.00044-16
13. Thomas-White K., Forster S.C., Kumar N., Van Kuiken M., Putonti C., Stares M.D., et al. Culturing of female bladder bacteria reveals an interconnected urogenital microbiota. Nat. Commun. 2018;9(1):1557. https://doi.org/10.1038/s41467-018-03968-5
14. Price T.K., Hilt E.E., Thomas-White K., Mueller E.R., Wolfe A.J., Brubaker L. The urobiome of continent adult women: a cross-sectional study. BJOG. 2020;127(2):193–201. https://doi.org/10.1111/1471-0528.15920
15. Moustafa A., Li W., Singh H., Moncera K.J., Torralba M.G., Yu Y., et al. Microbial metagenome of urinary tract infection. Sci. Rep. 2018;8(1):4333. https://doi.org/10.1038/s41598-018-22660-8
16. Quince C., Walker A.W., Simpson J.T., Loman N.J., Segata N. Shotgun metagenomics, from sampling to analysis. Nat. Biotechnol. 2017;35(9):833–844. https://doi.org/10.1038/nbt.3935
17. Karstens L., Asquith M., Caruso V., Rosenbaum J.T., Fair D.A., Braun J., et al. Community profiling of the urinary microbiota: considerations for low-biomass samples. Nat. Rev. Urol. 2018;15(12):735–749. https://doi.org/10.1038/s41585-018-0104-z
18. Barraud O., Ravry C., Francois B., Daix T., Ploy M.C., Vignon P. Shotgun metagenomics for microbiome and resistome detection in septic patients with urinary tract infections. Int. J. Antimicrob. Agents. 2019;54(6):803–808. https://doi.org/10.1016/j.ijantimicag.2019.09.009
19. Medina M., Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther. Adv. Urol. 2019 May 2;11:1756287219832172. https://doi.org/10.1177/1756287219832172
20. Whelan S., Lucey B., Finn K. Uropathogenic Escherichia coli (UPEC)-Associated Urinary Tract Infections: The Molecular Basis for Challenges to Effective Treatment. Microorganisms. 2023 Aug 28;11(9):2169. https://doi.org/10.3390/microorganisms11092169
21. Zilberberg M.D., Nathanson B.H., Sulham K., Shorr A.F. Descriptive epidemiology and outcomes of emergency department visits with complicated urinary tract infections in the United States, 2016-2018. J. Am. Coll. Emerg. Physicians Open. 2022 Mar 17;3(2):e12694. https://doi.org/10.1002/emp2.12694
22. Öztürk R., Murt A. Epidemiology of urological infections: a global burden. World J. Urol. 2020 Nov;38(11):2669-2679. https://doi.org/10.1007/s00345-019-03071-4
23. Baars C., van Ginkel C., Heesakkers J., Scholtes M., Martens F., Janssen D. The Burden of Urinary Tract Infections on Quality of Life and Healthcare in Patients with Interstitial Cystitis. Healthcare (Basel). 2023 Oct 18;11(20):2761. https://doi.org/10.3390/healthcare11202761
24. De Nisco N.J., Neugent M., Mull J., Chen L., Kuprasertkul A., de Souza Santos M., et al. Direct detection of tissue-resident bacteria and chronic inflammation in the bladder wall of postmenopausal women with recurrent urinary tract infection. J. Mol. Biol. 2019 Oct 4;431(21):4368–4379. https://doi.org/10.1016/j.jmb.2019.04.008
25. Forde B.M., Roberts L.W., Phan M.D., Peters K.M., Fleming B.A., Russell C.W., et al. Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection. Nat. Commun. 2019 Aug 13;10(1):3643. https://doi.org/10.1038/s41467-019-11571-5
26. Bolte L.A., Vich Vila A., Imhann F., Collij V., Gacesa R., Peters V., et al. Long-term dietary patterns are associated with pro-inflammatory and anti-inflammatory features of the gut microbiome. Gut. 2021 Jul;70(7):1287-1298. https://doi.org/10.1136/gutjnl-2020-322670
27. Chiba M., Tsuji T., Komatsu M. Therapeutic advancement in inflammatory bowel disease by incorporating plant-based diet. Transl. Gastroenterol. Hepatol. 2023 Sep 12;8:38. https://doi.org/10.21037/tgh-23-6 eCollection 2023.
28. Matzaras R., Anagnostou N., Nikopoulou A., Tsiakas I., Christaki E. The Role of Probiotics in Inflammation Associated with Major Surgery: A Narrative Review. Nutrients. 2023 Mar 8;15(6):1331. https://doi.org/10.3390/nu15061331
29. Kim Y.B., Whon T.W., Kim J.Y., Kim J., Kim Y., Lee S.H., et al. In-depth metataxonomic investigation reveals low richness, high intervariability, and diverse phylotype candidates of archaea in the human urogenital tract. Sci Rep. 2023 Jul 20;13(1):11746. https://doi.org/10.1038/s41598-023-38710-9
30. Mulder M., Radjabzadeh D., Hassing R.J., Heeringa J., Uitterlinden A.G., Kraaij R., et al. The effect of antimicrobial drug use on the composition of the genitourinary microbiota in an elderly population. BMC Microbiol. 2019 Jan 9;19(1):9. https://doi.org/10.1186/s12866-018-1379-1
2. Lloyd-Price J., Mahurkar A., Rahnavard G., Crabtree J., Orvis J., Hall A.B., et al. Strains, functions and dynamics in the expanded Human Microbiome Project. Nature. 2017;550(7674):61–66. https://doi.org/10.1038/nature23889
3. Aragón I.M., Herrera-Imbroda B., Queipo-Ortuño M.I., Castillo E., Del Moral J.S.-G., Gómez-Millán J., et al. The urinary tract microbiome in health and disease. Eur. Urol. Focus. 2018;4(1):128–138. https://doi.org/10.1016/j.euf.2016.11.001
4. Magistro G., Stief C.G. The urinary tract microbiome: the answer to all our open questions? Eur. Urol. Focus. 2019;5(1):36–38. https://doi.org/10.1016/j.euf.2018.06.011
5. Gilbert J.A., Blaser M.J., Caporaso J.G., Jansson J.K., Lynch S.V., Knight R. Current understanding of the human microbiome. Nat. Med. 2018;24(4):392–400. https://doi.org/10.1038/nm.4517
6. Shannon M.B., Limeira R., Johansen D., Gao X., Lin H., Dong Q., et al. Bladder urinary oxygen tension is correlated with urinary microbiota composition. Int. Urogynecol. J. 2019;30(8):1261–1267. https://doi.org/10.1007/s00192-019-03931-y
7. Amabebe E., Anumba D. The vaginal microenvironment: the physiologic role of lactobacilli. Front. Med. (Lausanne). 2018;5:181. https://doi.org/10.3389/fmed.2018.00181 eCollection 2018.
8. Reitzer L., Zimmern P. Rapid growth and metabolism of uropathogenic Escherichia coli in relation to urine composition. Clin. Microbiol. Rev. 2019;33(1):e00101-e00119. https://doi.org/10.1128/CMR.00101-19
9. Marotz CA, Sanders JG, Zuniga C, Zaramela LS, Knight R, Zengler K. 2018. Improving saliva shotgun metagenomics by chemical host DNA depletion. Microbiome 6:42. doi: 10.1186/s40168-018-0426-3.
10. Brubaker L., Wolfe A.J. The female urinary microbiota, urinary health and common urinary disorders. Ann. Transl. Med. 2017;5(2):34. https://doi.org/10.21037/atm.2016.11.62
11. Hilt E.E., McKinley K., Pearce M.M., Rosenfeld A.B., Zilliox M.J., Mueller E.R., et al. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J. Clin. Microbiol. 2014;52(3):871–876. https://doi.org/10.1128/JCM.02876-13
12. Price T.K., Dune T., Hilt E.E., Thomas-White K.J., Kliethermes S., Brincat C., et al. The clinical urine culture: enhanced techniques improve detection of clinically relevant microorganisms. J. Clin. Microbiol. 2016;54(5):1216–1222. https://doi .org/10.1128/JCM.00044-16
13. Thomas-White K., Forster S.C., Kumar N., Van Kuiken M., Putonti C., Stares M.D., et al. Culturing of female bladder bacteria reveals an interconnected urogenital microbiota. Nat. Commun. 2018;9(1):1557. https://doi.org/10.1038/s41467-018-03968-5
14. Price T.K., Hilt E.E., Thomas-White K., Mueller E.R., Wolfe A.J., Brubaker L. The urobiome of continent adult women: a cross-sectional study. BJOG. 2020;127(2):193–201. https://doi.org/10.1111/1471-0528.15920
15. Moustafa A., Li W., Singh H., Moncera K.J., Torralba M.G., Yu Y., et al. Microbial metagenome of urinary tract infection. Sci. Rep. 2018;8(1):4333. https://doi.org/10.1038/s41598-018-22660-8
16. Quince C., Walker A.W., Simpson J.T., Loman N.J., Segata N. Shotgun metagenomics, from sampling to analysis. Nat. Biotechnol. 2017;35(9):833–844. https://doi.org/10.1038/nbt.3935
17. Karstens L., Asquith M., Caruso V., Rosenbaum J.T., Fair D.A., Braun J., et al. Community profiling of the urinary microbiota: considerations for low-biomass samples. Nat. Rev. Urol. 2018;15(12):735–749. https://doi.org/10.1038/s41585-018-0104-z
18. Barraud O., Ravry C., Francois B., Daix T., Ploy M.C., Vignon P. Shotgun metagenomics for microbiome and resistome detection in septic patients with urinary tract infections. Int. J. Antimicrob. Agents. 2019;54(6):803–808. https://doi.org/10.1016/j.ijantimicag.2019.09.009
19. Medina M., Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther. Adv. Urol. 2019 May 2;11:1756287219832172. https://doi.org/10.1177/1756287219832172
20. Whelan S., Lucey B., Finn K. Uropathogenic Escherichia coli (UPEC)-Associated Urinary Tract Infections: The Molecular Basis for Challenges to Effective Treatment. Microorganisms. 2023 Aug 28;11(9):2169. https://doi.org/10.3390/microorganisms11092169
21. Zilberberg M.D., Nathanson B.H., Sulham K., Shorr A.F. Descriptive epidemiology and outcomes of emergency department visits with complicated urinary tract infections in the United States, 2016-2018. J. Am. Coll. Emerg. Physicians Open. 2022 Mar 17;3(2):e12694. https://doi.org/10.1002/emp2.12694
22. Öztürk R., Murt A. Epidemiology of urological infections: a global burden. World J. Urol. 2020 Nov;38(11):2669-2679. https://doi.org/10.1007/s00345-019-03071-4
23. Baars C., van Ginkel C., Heesakkers J., Scholtes M., Martens F., Janssen D. The Burden of Urinary Tract Infections on Quality of Life and Healthcare in Patients with Interstitial Cystitis. Healthcare (Basel). 2023 Oct 18;11(20):2761. https://doi.org/10.3390/healthcare11202761
24. De Nisco N.J., Neugent M., Mull J., Chen L., Kuprasertkul A., de Souza Santos M., et al. Direct detection of tissue-resident bacteria and chronic inflammation in the bladder wall of postmenopausal women with recurrent urinary tract infection. J. Mol. Biol. 2019 Oct 4;431(21):4368–4379. https://doi.org/10.1016/j.jmb.2019.04.008
25. Forde B.M., Roberts L.W., Phan M.D., Peters K.M., Fleming B.A., Russell C.W., et al. Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection. Nat. Commun. 2019 Aug 13;10(1):3643. https://doi.org/10.1038/s41467-019-11571-5
26. Bolte L.A., Vich Vila A., Imhann F., Collij V., Gacesa R., Peters V., et al. Long-term dietary patterns are associated with pro-inflammatory and anti-inflammatory features of the gut microbiome. Gut. 2021 Jul;70(7):1287-1298. https://doi.org/10.1136/gutjnl-2020-322670
27. Chiba M., Tsuji T., Komatsu M. Therapeutic advancement in inflammatory bowel disease by incorporating plant-based diet. Transl. Gastroenterol. Hepatol. 2023 Sep 12;8:38. https://doi.org/10.21037/tgh-23-6 eCollection 2023.
28. Matzaras R., Anagnostou N., Nikopoulou A., Tsiakas I., Christaki E. The Role of Probiotics in Inflammation Associated with Major Surgery: A Narrative Review. Nutrients. 2023 Mar 8;15(6):1331. https://doi.org/10.3390/nu15061331
29. Kim Y.B., Whon T.W., Kim J.Y., Kim J., Kim Y., Lee S.H., et al. In-depth metataxonomic investigation reveals low richness, high intervariability, and diverse phylotype candidates of archaea in the human urogenital tract. Sci Rep. 2023 Jul 20;13(1):11746. https://doi.org/10.1038/s41598-023-38710-9
30. Mulder M., Radjabzadeh D., Hassing R.J., Heeringa J., Uitterlinden A.G., Kraaij R., et al. The effect of antimicrobial drug use on the composition of the genitourinary microbiota in an elderly population. BMC Microbiol. 2019 Jan 9;19(1):9. https://doi.org/10.1186/s12866-018-1379-1
Опубликован
2024-04-11
Как цитировать
Евдокимова Н. В., Черненькая Т. В. Современный взгляд на микробиом мочевыводящих путей // Патологическая физиология и экспериментальная терапия. 2024. Т. 68. № 1. С. 138–144.
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