Urinary microbiome and psychology in women with overactive bladder

Abstract

Objective To characterize the female urinary microbiome associated to OAB (overactive bladder) and investigate relationships between urinary microbiome and psychological factors. Methods 30 women with OAB and 25 asymptomatic controls were recruited and required to finish the overactive bladder symptom score, self-rating anxiety scale, self-rating depression scale and quality of life questionaires. Urine specimens were collected by transurethral catheterization and processed for 16S rRNA gene sequencing. Sequencing reads were processed using QIIME. Analyses for bacterial genera biomarker was used LEfSe algorithms. Bivariate correlations were assessed using Pearson’s correlation. Results The two cohorts showed no significance difference in their demographic characteristics. OAB patients had significantly higher scores on overactive bladder symptom score, self-rating anxiety scale, self-rating depression scale and quality of life than controls (P<0.001). We found that bacterial diversity (Chao1 index: 1 854.09±1 239.34) and richness (Simpson index: 0.75±0.23) were decreased in OAB samples than those of controls (Chao1 index: 2 866.27±1 795.22; Simpson index: 0.86±0.12; P=0.02). At the family level, Enterobacteriaceae and (17.6% vs.8.1%; P=0.03) Bifidobacteriaceae (14.8% vs.3.6%; P=0.01) were significantly more abundant in the OAB samples than the controls. Compared to controls, 7 genera increased in OAB patients (e.g., Proteus and Aerococcus) and 13 reduced (e.g., Lactobacillus and Prevotella). There are negative correlations between scores on Self-Rating Depression Scale and both Chao1 (r=-0.458, P=0.011) and shannon indexes (r=-0.516, P=0.003) in OAB patients, which indicates that OAB patients with depression have further reductions in bacterial diversity and richness. Conclusions The aberrant urinary microbiome may serve as disease biomarkers and potential therapeutic targets of OAB. A negative correlation between depression scores and both bacterial richness and diversity in OAB patients indicated that there might be a connection between central nervous system and urinary microbiome. Key words: Overactive bladder; Urinary microbiome; Psychology