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Urinary microbiome differences between lichen sclerosus induced and non-lichen sclerosus induced urethral stricture disease

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Abstract

Objective

To describe differences in the urinary microbiome of patients with pathologically confirmed lichen sclerosus (LS) urethral stricture disease (USD) vs non-lichen sclerosus (non-LS) USD pre- and post-operatively.

Methods

Patients were pre-operatively identified and prospectively followed, all underwent surgical repair and had tissue samples obtained to make a pathological diagnosis of LS. Pre- and post-operative urine samples were collected. Bacterial genomic DNA was extracted. Alpha and beta diversity measurements were calculated and compared. A zero-inflated negative binomial model was utilized to compare taxa abundances between disease status and surgery status.

Results

Urine samples were obtained from both cohorts, 69 samples in total: 36 samples were obtained pre-operatively and 33 samples were obtained post-operatively. Ten patients provided both a pre-operative and post-operative urine sample. Twenty-six patients had pathological evidence of LS and 33 patients did not. There was a statistically significant difference in alpha diversity between the pre-operative urine samples of patients with non-LS USD and LS USD, (p = 0.01). There was no significant difference in alpha diversity within post-operative urine samples between patients with non-LS USD and LS USD, (p = 0.1). A significant difference was observed in Weighed UniFrac distances with respect to disease and operative status, (p = 0.001 and 0.002).

Conclusions

LS USD have significant alterations in diversity and differential abundance of urine microbiota compared to non-LS USD controls. These findings could be used to guide further investigations into the role of the urinary microbiome in LS USD pathogenesis, severity of presentation, and stricture recurrence.

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Authors and Affiliations

  1. Lahey Hospital and Medical Center, 41 Burlington Mall Road, Burlington, MA, 01805, USA

    Marcus L. Jamil, Aaron Perecman, Amanda Sherman, Travis Sullivan, Kimberly Christ, Alexandra Hansma, Eric Burks & Alex J. Vanni

  2. Tufts University, Medford, MA, USA

    Alexandra Hansma & Eric Burks

  3. Boston Medical Center, Boston, Massachusetts, USA

    Eric Burks

Authors
  1. Marcus L. Jamil
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  2. Aaron Perecman
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  3. Amanda Sherman
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  4. Travis Sullivan
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  5. Kimberly Christ
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  6. Alexandra Hansma
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Contributions

M Jamil: Protocol/project development, Data collection or management, Data analysis, Manuscript writing/editing. A Perecman: Protocol/project development, Data collection or management. A Sherman: Protocol/project development, Data collection or management. T Sullivan: Protocol/project development, Data collection or management, Data analysis, Manuscript writing/editing. K Christ: Protocol/project development, Data collection or management, Data analysis, Manuscript writing/editing. A Hansma: Data collection or management, Data analysis. E Burks: Data collection or management, Data analysis,. A Vanni: Protocol/project development, Data collection or management, Data analysis, Manuscript writing/editing.

Corresponding author

Correspondence to Alex J. Vanni.

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Conflicts of interest

No conflicts of interest to disclose for all authors involved.

Research involving human participants and/or animals

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Lahey Hospital and Medical Center.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary File 1: Microbiome Analysis Statistical Methods

345_2023_4490_MOESM2_ESM.pdf

Supplementary Figure 1: Beta diversity group comparison based on unweighted UniFrac distances. Abbreviations: LS; Lichen Sclerosus non-LS; Non Lichen Sclerosus, PC; Principal coordinates

345_2023_4490_MOESM3_ESM.pdf

Supplementary Figure 2: Beta diversity group comparison based Bray Curtis distances Abbreviations: LS; Lichen Sclerosus non-LS; Non Lichen Sclerosus, PC; Principal coordinates

345_2023_4490_MOESM4_ESM.png

Supplementary Figure 3: Stacked barplot demonstrating the relative abundances of taxa at the phylum and order levels level for all samples with and without Lichen Sclerosus further stratified by pre and post-operative status. Abbreviations: LS; Lichen Sclerosus non-LS; Non Lichen Sclerosus

345_2023_4490_MOESM5_ESM.pdf

Supplementary Figure 4: Comparison of Shannon diversity between the pre-operative and post-operative non-Lichen Sclerosis and Lichen Sclerosis groups stratified by Lichen Sclerosis disease score

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Jamil, M.L., Perecman, A., Sherman, A. et al. Urinary microbiome differences between lichen sclerosus induced and non-lichen sclerosus induced urethral stricture disease. World J Urol 41, 2495–2501 (2023). https://doi.org/10.1007/s00345-023-04490-0

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  • DOI: https://doi.org/10.1007/s00345-023-04490-0

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