urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2020-8-3-85-96urovest-368Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESВлияет ли ботулинотерапия на микробиом мочи больных нейрогенным мочевым пузырём? Результаты метагеномного секвенированияDoes botulinum therapy affect the urine microbiome of patients with neurogenic bladder? Metagenomic sequencing resultshttps://orcid.org/0000-0003-3065-3953ФилипповаЕ. С.PhilippovaE. S.

Екатерина Сергеевна Филиппова ‒ кандидат медицинских наук; доцент кафедры урологии УрГМУ; врач-уролог свердловской областной клинической больницы №1

620028, Екатеринбург, ул. Репина, д. 3; 620102, Екатеринбург, ул. Волгоградская, д. 185, тел.: +7 (912) 638-02-86

Ekaterina S. Philippova - M.D., Cand.Sc. (M); Assist. Prof., Dept. of Urology, Ural SMU; Urologist, Urological Division No.3, Sverdlovsk RH No.1.

620028, Yekaterinburg, 3 Repina str.; 620102, Yekaterinburg, 185 Volgogradskaya str. ; tel.: +7 (912) 638-02-86

filippova.cat@yandex.ruhttps://orcid.org/0000-0003-1745-700XБаженовИ. В.BazhenovI. V.

Игорь Владимирович Баженов - доктор медицинских наук, профессор; профессор кафедры урологии УрГМУ; заведующий 3 урологическим отделением Свердловской ОКБ № 1.

620028, Екатеринбург, ул. Репина, д. 3; 620102, Екатеринбург, ул. Волгоградская, д. 185

Igor V. Bazhenov - M.D. Dr. Sc. (M), Full Prof.; Prof., Dept. of Urology, Ural SMU; Head, Urological Division No.3, Sverdlovsk RH No.1.

620028, Yekaterinburg, 3 Repina str.; 620102, Yekaterinburg, 185 Volgogradskaya str.

biv@okb1.ruhttps://orcid.org/0000-0001-8105-7233ЗыряновА. В.ZyrianovA. V.

Александр Владимирович Зырянов - доктор медицинских наук, профессор; заведующий кафедрой урологии УрГМУ; руководитель Областного урологического центра Свердловской ОКБ №1.

620028, Екатеринбург, ул. Репина, д. 3; 620102, Екатеринбург, ул. Волгоградская, д. 185

Alexander V. Ziryanov - M.D. Dr. Sc. (M), Full Prof.; Head, Dept. of Urology, Ural SMU; Head, Regional Urological Center, Sverdlovsk RH No.1.

620028, Yekaterinburg, 3 Repina str.; 620102, Yekaterinburg, 185 Volgogradskaya str.

zav1965@mail.ruФГБОУ ВО «Уральский государственный медицинский университет» Минздрава России; ГБУЗ СО Свердловская областная клиническая больница №1РоссияUral State Medical University; Sverdlovsk Regional Clinical Hospital No.1Russian Federation202004102020838596Copyright © Филиппова Е.С., Баженов И.В., Зырянов А.В., 20202020Филиппова Е.С., Баженов И.В., Зырянов А.В.Philippova E.S., Bazhenov I.V., Zyrianov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/368Введение

Введение. Реорганизация микробиома мочи больных нейрогенным мочевым пузырем играет важную роль в патогенезе инфекции мочевыводящих путей (ИМп). сведения о составе мочевого микробиома при нейрогенной дисфункции нижних мочевыводящих путей (НДНМп) ограничены, в частности, неизвестно, как на него влияют различные виды терапии НДНМп.

Цель исследования

Цель исследования. Оценить влияние инъекций ботулинического токсина на микробиом мочи больных НДНМп.

Материалы и методы

Материалы и методы. Образцы мочи были взяты у шести пациентов с НДНМп (четырёх женщин и двух мужчин) до введения 200 ЕД ботулинического токсина типа А в стенку мочевого пузыря и через 6 недель после. Образцы исследовали методом микроскопии, выполняли посев на микробиологические среды, а также метагеномное 16S рРНК секвенирование. с использованием платформы IlluminaMiSeq получено, в общей сложности, 144 562 16S рДНК прочтений.

Результаты

Результаты. Результаты посевов мочи коррелировали с данными 16S рРНК секвенирования, однако анализ метагенома позволил выявить и идентифицировать большее количество микроорганизмов. В каждом образце выделено от 2 до 21 рода микроорганизмов. В моче всех больных до ботулинотерапии преобладали Enterobacterales. после ботулинотерапии у трех пациенток, на фоне клинического и уродинамического улучшения, произошла смена микрофлоры с преобладанием Enterobacterales на Lactobacillales. В остальных случаях принципиальных изменений микробиома отмечено не было.

Заключение

Заключение. Впервые в рамках пилотного исследование проведено сравнение микробиома мочи у больных НДНМп до и после введения ботулинического токсина. Небольшое число участников является существенным ограничением данной работы, однако продемонстрирована возможность положительного влияния ботулинотерапии на микрофлору мочевыводящих путей.

Introduction

Introduction. Reorganization of the urinary microbiome in patients with neurogenic low urinary tract dysfunction (NLUTD) plays an important role in the pathogenesis of urinary tract infections (UTIs). However, we still do not know how the different types of NULTD therapy affect the microbiome.

Purpose of the study

Purpose of the study. Was to assess the influence of botulinum toxin (BoNT) injections on the urinary microbiome.

Materials and methods

Materials and methods. Urine samples were obtained from 6 persons (4 females and 2 males) with NLUTD before BoNT therapy (200 UI) and 6 weeks after. Standard urine analysis, urine culture and 16S rRNA gene sequencing were performed. a total of 144,562 quality-filtered 16S rDNA sequence reads were processed through an Illumina MiSeq platform.

Results

Results. The results of the urine culture correlated with 16S rRNA sequencing results, but the greater number of bacterial taxa were detected. Analysis of the bacterial community in urine samples revealed between 2 and 21 species-level reads per individual. All patients before BoNT demonstrated abnormal urinary microbiome with a predominance of Enterobacteriales. In three cases in females, clinical and urodynamic improvement after botulinum therapy was associated with changing of the microbiome from Enterobacteriaceae to Lactobacillales. In one female and two males, no principal changes had happened.

Conclusions

Conclusions. This is the first report comparing in pilot study the urinary microbiome before and after BoNT injections into the bladder wall. The results are restricted by the small number of participants. However, the promising observation about the influence of botulinum toxin therapy on urinary microbiome was obtained.

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The authors declare that there are no conflicts of interest present.