MP29-10 ALTERATIONS IN THE URINARY FUNGAL MYCOBIOME IN PATIENTS WITH BLADDER PAIN AND URINARY URGENCY

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis II1 Apr 2017MP29-10 ALTERATIONS IN THE URINARY FUNGAL MYCOBIOME IN PATIENTS WITH BLADDER PAIN AND URINARY URGENCY A. Lenore Ackerman, Jennifer Anger, Jie Tang, Karyn Eilber, Jayoung Kim, Michael Freeman, David Underhill, and MAPP Research Network A. Lenore AckermanA. Lenore Ackerman More articles by this author , Jennifer AngerJennifer Anger More articles by this author , Jie TangJie Tang More articles by this author , Karyn EilberKaryn Eilber More articles by this author , Jayoung KimJayoung Kim More articles by this author , Michael FreemanMichael Freeman More articles by this author , David UnderhillDavid Underhill More articles by this author , and MAPP Research NetworkMAPP Research Network More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.922AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate the influence of host-microbe interactions on lower urinary tract symptoms, we characterized changes in urinary fungal communities (the “mycobiome”) associated with urinary urgency and bladder pain. While alterations in the urinary bacterial microbiome are found in interstitial cystitis/bladder pain syndrome (IC/PBS) and overactive bladder (OAB), urinary fungal populations have remained completely uncharacterized, despite recent evidence implicating fungi in association with flare in chronic pelvic pain syndromes. METHODS Catheterized urine specimens were obtained from IC/PBS (n=12), OAB (n=17), and asymptomatic patients (n=14). After centrifugation, DNA was extracted from the cellular pellet. Following deep sequencing of the ITS1 fungal ribosomal gene, fungal taxa were identified by comparison to multiple fungal sequence databases. Using validated questionnaire data [the Genitourinary Pain Index (GUPI), OAB Questionnaire (OABq) and O'Leary-Sant Indices (ICSI/ICPI)], subjects were separated into tertiles based on symptomatic scores. Fungal community representation for each tertile was then examined while blinding for diagnosis. RESULTS Comparison of microbial communities between the subjects with the lowest and highest scores on the GUPI, OABq, and ICSI/ICPI revealed decreased fungal diversity for patients with more severe symptoms, regardless of symptom type. Individual symptoms were associated with distinctive species profiles, regardless of diagnosis (Figure). Patients with severe bladder pain exhibited altered Malassezia spp. composition, while fear of leakage was inversely correlated with detectable Wickerhamomyces spp. CONCLUSIONS The urinary mycobiome is altered in lower urinary tract symptoms, with loss of diversity correlating positively with symptom severity. Specific fungal community patterns correlated independently with painful bladder and urinary urgency symptoms. These results suggest the intriguing possibility that particular microbial patterns may be associated with specific symptoms, not necessarily diagnoses, which has important implications for future studies of the urinary tract microbiome and the development of diagnostic and treatment algorithms in LUTS. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e383-e384 Advertisement Copyright & Permissions© 2017MetricsAuthor Information A. Lenore Ackerman More articles by this author Jennifer Anger More articles by this author Jie Tang More articles by this author Karyn Eilber More articles by this author Jayoung Kim More articles by this author Michael Freeman More articles by this author David Underhill More articles by this author MAPP Research Network More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...