目的:全面回顾并严格评估间质性膀胱炎(IC)/膀胱疼痛综合征(BPS)患者与正常对照组之间的微生物群差异,并提供临床实践指南。
方法:在这篇系统综述中,我们评估了先前关于IC/BPS与正常对照之间微生物群差异的研究,以及IC/BPS亚群之间的区别。在PubMed/MEDLINE进行了全面的文献检索,EMBASE,WebofScience,和Cochrane中央受控试验登记册。相关研究根据预定的纳入和排除标准入围,其次是质量评估。主要重点是确定这些队列中的特定分类学差异。
结果:共有12项研究符合选择标准。第三审稿人裁定了差异。纽卡斯尔-渥太华量表用于评估研究质量。主要是,研究集中在IC/BPS患者和正常对照组之间的尿液微生物群差异,一项研究检查了各组之间的肠道微生物群差异,和两项研究探索阴道微生物群的区别。不幸的是,对其他微生物群差异的分析有限.我们的发现揭示了不同细菌丰度变化的证据,特别是涉及乳酸菌,与对照组相比,IC/BPS患者中特定代谢物的变化。
结论:目前,有证据表明,诊断为IC/BPS的个体与对照组之间的尿液微生物群多样性和物种组成存在显着差异。在可预见的未来,泌尿科医师应将尿液微生物群失调视为IC的潜在病因,对诊断和治疗有潜在的临床意义。
OBJECTIVE: To comprehensively review and critically assess the literature on microbiota differences between patients with interstitial cystitis (IC)/bladder pain syndrome (BPS) and normal controls and to provide clinical practice guidelines.
METHODS: In this systematic review, we evaluated previous research on microbiota disparities between IC/BPS and normal controls, as well as distinctions among IC/BPS subgroups. A comprehensive literature search was conducted across PubMed/MEDLINE, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials. Relevant studies were shortlisted based on predetermined inclusion and exclusion criteria, followed by quality assessment. The primary focus was identifying specific taxonomic variations among these cohorts.
RESULTS: A total of 12 studies met the selection criteria. Discrepancies were adjudicated by a third reviewer. The Newcastle-Ottawa Scale was used to assess study quality. Predominantly, the studies focused on disparities in urine microbiota between IC/BPS patients and normal controls, with one study examining gut microbiota differences between the groups, and two studies exploring vaginal microbiota distinctions. Unfortunately, analyses of discrepancies in other microbiota were limited. Our findings revealed evidence of distinct bacterial abundance variations, particularly involving Lactobacillus, alongside variations in specific metabolites among IC/BPS patients compared to controls.
CONCLUSIONS: Currently, there is evidence suggesting significant variations in the diversity and species composition of the urinary microbiota between individuals diagnosed with IC/BPS and control groups. In the foreseeable future, urologists should consider urine microbiota dysbiosis as a potential aetiology for IC, with potential clinical implications for diagnosis and treatment.