Sun Alec, Rodriguez-Alvarez Juan Sebastian, Harper Shelby, Khooblall Prajit, Dang Thien, De Smita, Miller Aaron W
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland, Ohio, USA.
Prostate. 2025 Jun;85(9):850-859. doi: 10.1002/pros.24891. Epub 2025 Mar 24.
The etiology of benign prostatic hyperplasia (BPH) is not well understood, though recent literature suggests that the urinary tract microbiome may play a role. We aimed to examine the prostatic microbiome in BPH and its associations with patient characteristics.
Men undergoing Holmium Laser Enucleation of the Prostate (HoLEP) were recruited if they were over 18 years old and had no history of prostate cancer, prostate surgery, or pelvic radiation. Exclusion criteria included positive preoperative urine culture, bladder stones, or catheter-dependence. Patient characteristics including age, prostate-specific antigen (PSA), American Urological Association symptom score (AUASS), and history of biopsy were recorded. Intraoperatively, prostate tissue was collected from each patient, as well as catheterized urine, urethral swabs, and swabs of the specimen container. Samples underwent DNA extraction, 16S sequencing, and analysis using R statistical software. Associations between bacterial taxonomic diversity and patient characteristics were quantified through Sparcc correlations.
Fifty patients were recruited. Mean age, PSA, prostate size, and AUASS were 67.8 years, 4.0 ng/mL, 108.6 g, and 19.4, respectively. After bioinformatic decontamination of prostate samples, alpha and beta diversity analyses indicated that microbiomes from the prostate, urethra, and urine were all distinct (p = 0.001); microbiota from the urine and urethra had higher similarity to each other than that of the prostate. Campylobacter, Caryophanaceae, Enterobacter, and Senegalimassilia positively correlated with prostate size or PSA.
The prostatic microbiome is unique and distinct from that of urine and urethra, with several known pathogens positively correlating with prostate size and PSA.
良性前列腺增生（BPH）的病因尚未完全明确，不过近期文献表明尿路微生物群可能发挥了一定作用。我们旨在研究BPH患者的前列腺微生物群及其与患者特征的关联。
招募年龄超过18岁、无前列腺癌、前列腺手术或盆腔放疗史且接受钬激光前列腺剜除术（HoLEP）的男性。排除标准包括术前尿培养阳性、膀胱结石或依赖导尿管。记录患者的年龄、前列腺特异性抗原（PSA）、美国泌尿外科学会症状评分（AUASS）及活检史等特征。术中，从每位患者采集前列腺组织、导尿尿液、尿道拭子及标本容器拭子。样本进行DNA提取、16S测序，并使用R统计软件进行分析。通过Sparcc相关性定量分析细菌分类多样性与患者特征之间的关联。
共招募50名患者。平均年龄、PSA、前列腺体积和AUASS分别为67.8岁、4.0 ng/mL、108.6 g和19.4。对前列腺样本进行生物信息净化后，α和β多样性分析表明，来自前列腺、尿道和尿液的微生物群均不同（p = 0.001）；尿液和尿道的微生物群彼此之间的相似性高于与前列腺微生物群的相似性。弯曲杆菌、嘉利翁菌科、肠杆菌和塞内加尔马西利亚菌与前列腺体积或PSA呈正相关。
前列腺微生物群独特，与尿液和尿道的微生物群不同，几种已知病原体与前列腺体积和PSA呈正相关。
