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Published in: World Journal of Urology 2/2020

01-02-2020 | Malassezia | Original Article

Urinary fungi associated with urinary symptom severity among women with interstitial cystitis/bladder pain syndrome (IC/BPS)

Authors: J. Curtis Nickel, Alisa Stephens, J. Richard Landis, Chris Mullins, Adrie van Bokhoven, Jennifer T. Anger, A. Lenore Ackerman, Jayoung Kim, Siobhan Sutcliffe, Jaroslaw E. Krol, Bhaswati Sen, Jocelyn Hammond, Garth D. Ehrlich, The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network

Published in: World Journal of Urology | Issue 2/2020

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Abstract

Purpose

To correlate the presence of fungi with symptom flares, pain and urinary severity in a prospective, longitudinal study of women with IC/BPS enrolled in the MAPP Research Network.

Methods

Flare status, pelvic pain, urinary severity, and midstream urine were collected at baseline, 6 and 12 months from female IC/BPS participants with at least one flare and age-matched participants with no reported flares. Multilocus PCR coupled with electrospray ionization/mass spectrometry was used for identification of fungal species and genus. Associations between “mycobiome” (species/genus presence, relative abundance, Shannon’s/Chao1 diversity indices) and current flare status, pain, urinary severity were evaluated using generalized linear mixed models, permutational multivariate analysis of variance, Wilcoxon’s rank-sum test.

Results

The most specific analysis detected 13 fungal species from 8 genera in 504 urine samples from 202 females. A more sensitive analysis detected 43 genera. No overall differences were observed in fungal species/genus composition or diversity by flare status or pain severity. Longitudinal analyses suggested greater fungal diversity (Chao1 Mean Ratio 3.8, 95% CI 1.3–11.2, p = 0.02) and a significantly greater likelihood of detecting any fungal species (OR = 5.26, 95% CI 1.1–25.8, p = 0.04) in high vs low urinary severity participants. Individual taxa analysis showed a trend toward increased presence and relative abundance of Candida (OR = 6.63, 95% CI 0.8–58.5, p = 0.088) and Malassezia (only identified in ‘high’ urinary severity phenotype) for high vs low urinary symptoms.

Conclusion

This analysis suggests the possibility that greater urinary symptom severity is associated with the urinary mycobiome urine in some females with IC/BPS.
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Literature
1.
go back to reference Sutcliffe S, Colditz GA, Goodman MS et al (2014) Urological chronic pelvic pain syndrome symptom flares: characterization of the full range of flares at two sites in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. BJU Int 114:916–925CrossRef Sutcliffe S, Colditz GA, Goodman MS et al (2014) Urological chronic pelvic pain syndrome symptom flares: characterization of the full range of flares at two sites in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. BJU Int 114:916–925CrossRef
4.
go back to reference Nickel JC, Stephens A, Landis JR et al (2016) Assessment of the lower urinary tract microbiota during symptom flare in women with urologic chronic pelvic pain syndrome: a MAPP Network Study. J Urol 195:356–362CrossRef Nickel JC, Stephens A, Landis JR et al (2016) Assessment of the lower urinary tract microbiota during symptom flare in women with urologic chronic pelvic pain syndrome: a MAPP Network Study. J Urol 195:356–362CrossRef
6.
go back to reference Griffith JW, Stephens-Shields AJ, Hou X et al (2016) Pain and urinary symptoms should not be combined into a single score: psychometric findings from the MAPP Research Network. J Urol 195:949–954CrossRef Griffith JW, Stephens-Shields AJ, Hou X et al (2016) Pain and urinary symptoms should not be combined into a single score: psychometric findings from the MAPP Research Network. J Urol 195:949–954CrossRef
8.
go back to reference Shin JH, Ranken R, Sefers SE et al (2013) Detection, identification, and distribution of fungi in bronchoalveolar lavage specimens by use of multilocus PCR coupled with electrospray ionization/mass spectrometry. J Clin Microbiol 51:136–141CrossRef Shin JH, Ranken R, Sefers SE et al (2013) Detection, identification, and distribution of fungi in bronchoalveolar lavage specimens by use of multilocus PCR coupled with electrospray ionization/mass spectrometry. J Clin Microbiol 51:136–141CrossRef
9.
go back to reference Nickel JC, Stephens A, Landis R et al (2015) Search for microorganisms in men with urologic chronic pelvic pain syndrome: a culture-independent analysis in the MAPP research network. J Urol 194:127–135CrossRef Nickel JC, Stephens A, Landis R et al (2015) Search for microorganisms in men with urologic chronic pelvic pain syndrome: a culture-independent analysis in the MAPP research network. J Urol 194:127–135CrossRef
10.
go back to reference Chao A (1984) Non-parametric estimation of the number of classes in a population. Scand J Stat 11:265–270 Chao A (1984) Non-parametric estimation of the number of classes in a population. Scand J Stat 11:265–270
11.
go back to reference Shannon CE, Weaver W (1949) The mathematical theory of communication. The University of Illinois Press, Urbana, p 117 Shannon CE, Weaver W (1949) The mathematical theory of communication. The University of Illinois Press, Urbana, p 117
12.
go back to reference Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc B 57:289–300 Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc B 57:289–300
19.
go back to reference Fok CS, Gao X, Lin H et al (2018) Urinary symptoms are associated with certain urinary microbes in urogynecologic surgical patients. Int Urogynecol J 29:1765–1771CrossRef Fok CS, Gao X, Lin H et al (2018) Urinary symptoms are associated with certain urinary microbes in urogynecologic surgical patients. Int Urogynecol J 29:1765–1771CrossRef
20.
go back to reference Fouts DE, Pieper R, Szpakowski S et al (2012) Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med 28(10):174. https://doi.org/10.1186/1479-5876-10-174 CrossRef Fouts DE, Pieper R, Szpakowski S et al (2012) Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med 28(10):174. https://​doi.​org/​10.​1186/​1479-5876-10-174 CrossRef
25.
go back to reference Ott SJ, Kühbacher T, Musfeldt M et al (2008) Fungi and inflammatory bowel diseases: alterations of composition and diversity. Scand J Gastroenterol 43:831–841CrossRef Ott SJ, Kühbacher T, Musfeldt M et al (2008) Fungi and inflammatory bowel diseases: alterations of composition and diversity. Scand J Gastroenterol 43:831–841CrossRef
27.
go back to reference Knutsen AP, Bush RK, Demain JG et al (2012) Fungi and allergic lower respiratory tract diseases. J Allergy Clin Immunol 129:280–291CrossRef Knutsen AP, Bush RK, Demain JG et al (2012) Fungi and allergic lower respiratory tract diseases. J Allergy Clin Immunol 129:280–291CrossRef
28.
go back to reference Sokol H, Leducq V, Aschard H et al (2017) Fungal microbiota dysbiosis in IBD. Gut 66:1039–1048CrossRef Sokol H, Leducq V, Aschard H et al (2017) Fungal microbiota dysbiosis in IBD. Gut 66:1039–1048CrossRef
Metadata
Title
Urinary fungi associated with urinary symptom severity among women with interstitial cystitis/bladder pain syndrome (IC/BPS)
Authors
J. Curtis Nickel
Alisa Stephens
J. Richard Landis
Chris Mullins
Adrie van Bokhoven
Jennifer T. Anger
A. Lenore Ackerman
Jayoung Kim
Siobhan Sutcliffe
Jaroslaw E. Krol
Bhaswati Sen
Jocelyn Hammond
Garth D. Ehrlich
The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 2/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-019-02764-0

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