Inflammation and infection are causative factors of benign prostatic hyperplasia (BPH). Urine is not sterile, and urine microbiota identified by DNA sequencing can play an important role in the development of BPH and can influence the severity of lower urinary tract symptoms (LUTS). We collected mid-stream voided urine samples from BPH patients and control participants and stored them in a freezer at − 80 °C. All enrolled participants were requested to provide information about their clinical characteristics and complete the International Prostate Symptom Score (IPSS) questionnaire. Each step of the procedure, including the extraction of the genomic DNA from the urine samples; the amplification by polymerase chain reaction (PCR); PCR product quantification, mixing, and purification; DNA library preparation; and sequencing was performed with quality control (QC) measures. Alpha diversity was indicative of the species complexity within individual urine samples, and beta diversity analysis was used to evaluate the differences among the samples in terms of species complexity. Pearson’s correlation analysis was performed to calculate the relationship between the clinical characteristics of the participants and the microbiota species in the urine samples. We enrolled 77 BPH patients and 30 control participants who reported no recent antibiotic usage. Old age, high IPSS and poor quality of life were observed in the participants of the BPH group. No significant differences were observed in the alpha diversity of the samples. In the beta diversity analysis, there was a significant difference between the microbiota in the samples of the BPH and control groups according to ANOSIM statistical analysis. On comparing the groups, the ten bacterial genera present in the samples of the BPH group in descending order of abundance were: Sphingomonas, Bacteroides, Lactobacillus, Streptococcus, Alcaligenes, Prevotella, Ruminococcaceae UCG-014, Escherichia_Shigella, Akkermansia, and Parabacteroides. Spearman’s correlation analysis revealed that urine samples showing the presence of the bacterial genera Haemophilus, Staphylococcus, Dolosigranulum, Listeria, Phascolarctobacterium, Enhydrobacter, Bacillus, [Ruminococcus]torques, Faecalibacterium, and Finegoldia correlated with a high IPSS, and severe storage and voiding symptoms (P < 0.05). Our current study shows that dysbiosis of urine microbiota may be related to the development of BPH and the severity of LUTS. Further research targeting specific microbes to identify their role in the development of diseases is necessary and might provide novel diagnostic biomarkers and therapeutic options.

中文翻译：

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尿液微生物群对下尿路症状患者的影响

炎症和感染是良性前列腺增生（BPH）的致病因素。尿液不是无菌的，通过 DNA 测序鉴定的尿液微生物群可以在 BPH 的发展中发挥重要作用，并可以影响下尿路症状 (LUTS) 的严重程度。我们收集了 BPH 患者和对照组参与者的中流排尿样本，并将它们储存在 - 80 °C 的冰箱中。要求所有登记的参与者提供有关其临床特征的信息并完成国际前列腺症状评分 (IPSS) 问卷。程序的每个步骤，包括从尿液样本中提取基因组 DNA；聚合酶链反应（PCR）扩增；PCR产物定量、混合、纯化；DNA文库制备；并通过质量控制 (QC) 措施进行测序。阿尔法多样性表示个体尿液样本中的物种复杂性，而贝塔多样性分析用于评估样本之间在物种复杂性方面的差异。进行 Pearson 相关分析以计算参与者的临床特征与尿液样本中微生物群种类之间的关系。我们招募了 77 名 BPH 患者和 30 名报告近期未使用抗生素的对照参与者。在 BPH 组的参与者中观察到高龄、高 IPSS 和较差的生活质量。样本的 alpha 多样性没有观察到显着差异。在β多样性分析中，根据 ANOSIM 统计分析，BPH 和对照组样本中的微生物群之间存在显着差异。在比较各组时，BPH 组样品中存在的十个细菌属按丰度降序排列为：鞘氨醇单胞菌属、拟杆菌属、乳杆菌属、链球菌属、产碱杆菌属、普氏菌属、瘤胃球菌科 UCG-014、埃希氏菌属_志贺氏菌属、阿克曼氏菌属和副杆菌属。Spearman 的相关性分析显示，尿液样本显示存在嗜血杆菌属、葡萄球菌属、Dolosigranulum 属、李斯特菌属、嗜酸杆菌属、Enhydrobacter 杆菌属、芽孢杆菌属、[Ruminococcus]torques、Faecalibacterium 和 Finegoldia 属与高 IPSS 以及严重的储存和排尿症状相关（ P < 0.05)。我们目前的研究表明，尿液微生物群的失调可能与 BPH 的发展和 LUTS 的严重程度有关。针对特定微生物的进一步研究以确定它们在疾病发展中的作用是必要的，并且可能提供新的诊断生物标志物和治疗选择。