Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Comparative and Molecular Pathobiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Prostate Cancer Prostatic Dis. 2018 Sep;21(3):345-354. doi: 10.1038/s41391-018-0041-1. Epub 2018 May 23.
The human microbiome may influence prostate cancer initiation and/or progression through both direct and indirect interactions. To date, the majority of studies have focused on direct interactions including the influence of prostate infections on prostate cancer risk and, more recently, on the composition of the urinary microbiome in relation to prostate cancer. Less well understood are indirect interactions of the microbiome with prostate cancer, such as the influence of the gastrointestinal or oral microbiota on pro- or anti-carcinogenic xenobiotic metabolism, and treatment response.
We review the literature to date on direct and indirect interactions of the microbiome with prostate inflammation and prostate cancer.
Emerging studies indicate that the microbiome can influence prostate inflammation in relation to benign prostate conditions such as prostatitis/chronic pelvic pain syndrome and benign prostatic hyperplasia, as well as in prostate cancer. We provide evidence that the human microbiome present at multiple anatomic sites (urinary tract, gastrointestinal tract, oral cavity, etc.) may play an important role in prostate health and disease.
In health, the microbiome encourages homeostasis and helps educate the immune system. In dysbiosis, a systemic inflammatory state may be induced, predisposing remote anatomical sites to disease, including cancer. The microbiome's ability to affect systemic hormone levels may also be important, particularly in a disease such as prostate cancer that is dually affected by estrogen and androgen levels. Due to the complexity of the potential interconnectedness between prostate cancer and the microbiome, it is vital to further explore and understand the relationships that are involved.
人类微生物组可能通过直接和间接相互作用影响前列腺癌的发生和/或进展。迄今为止，大多数研究都集中在直接相互作用上，包括前列腺感染对前列腺癌风险的影响，以及最近对与前列腺癌相关的尿微生物组组成的研究。微生物组与前列腺癌之间的间接相互作用，如胃肠道或口腔微生物群对前致癌或抗致癌异生物质代谢以及治疗反应的影响，了解较少。
我们回顾了迄今为止关于微生物组与前列腺炎症和前列腺癌的直接和间接相互作用的文献。
新出现的研究表明，微生物组可以影响与良性前列腺疾病（如前列腺炎/慢性骨盆疼痛综合征和良性前列腺增生）以及前列腺癌相关的前列腺炎症。我们有证据表明，存在于多个解剖部位（尿路、胃肠道、口腔等）的人类微生物组可能在前列腺健康和疾病中发挥重要作用。
在健康状态下，微生物组鼓励体内平衡并帮助免疫系统接受教育。在生态失调中，可能会引发全身性炎症状态，使远程解剖部位易患疾病，包括癌症。微生物组影响全身激素水平的能力也可能很重要，特别是在前列腺癌等同时受雌激素和雄激素水平影响的疾病中。由于前列腺癌和微生物组之间潜在的相互联系的复杂性，进一步探索和理解所涉及的关系至关重要。
