Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
Crit Rev Microbiol. 2023 Mar;49(2):177-196. doi: 10.1080/1040841X.2022.2045899. Epub 2022 Jul 1.
Urolithiasis, referred to as the formation of stones in the urinary tract, is a common disease with growing prevalence and high recurrence rate worldwide. Although researchers have endeavoured to explore the mechanism of urinary stone formation for novel effective therapeutic and preventative measures, the exact aetiology and pathogenesis remain unclear. Propelled by sequencing technologies and culturomics, great advances have been made in understanding the pivotal contribution of the human microbiome to urolithiasis. Indeed, there are diverse and abundant microbes interacting with the host in the urinary tract, overturning the dogma that urinary system, and urine are sterile. The urinary microbiome of stone formers was clearly distinct from healthy individuals. Besides, dysbiosis of the intestinal microbiome appears to be involved in stone formation through the gut-kidney axis. Thus, the human microbiome has potential significant implications for the aetiology of urolithiasis, providing a novel insight into diagnostic, therapeutic, and prognostic strategies. Herein, we review and summarize the landmark microbiome studies in urolithiasis and identify therapeutic implications, challenges, and future perspectives in this rapidly evolving field. To conclude, a new front has opened with the evidence for a microbial role in stone formation, offering potential applications in the prevention, and treatment of urolithiasis.
尿石症,又称尿路结石,是一种在全球范围内发病率不断增加、复发率较高的常见疾病。尽管研究人员努力探索尿石形成的机制,以寻求新的有效治疗和预防措施,但确切的病因和发病机制仍不清楚。随着测序技术和培养组学的发展,人们对人类微生物组在尿石症中的关键作用有了更深入的了解。事实上,在尿路中存在着与宿主相互作用的多种丰富的微生物,这颠覆了泌尿系统和尿液无菌的传统观念。结石形成者的尿微生物组明显不同于健康个体。此外,肠道微生物组的失调似乎通过肠-肾轴参与了结石的形成。因此,人类微生物组对尿石症的病因具有潜在的重要意义,为诊断、治疗和预后策略提供了新的视角。在此,我们回顾和总结了尿石症领域的重要微生物组研究,并确定了该领域的治疗意义、挑战和未来展望。总之,随着微生物在结石形成中的作用的证据不断增加,为尿石症的预防和治疗开辟了新的应用前景。