Urinary Microbiome and Psychological Factors in Women with Overactive BladderOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
This study characterized the female urinary microbiome in overactive bladder (OAB) and examined how it relates to psychological factors. Researchers sequenced the V4 region of the 16S rRNA gene from catheter-collected urine. Participants completed the Overactive Bladder Symptom Score, a Self-Rating Anxiety Scale, and a Self-Rating Depression Scale. Urine was collected by transurethral catheter to avoid contamination, and standard culture excluded urinary tract infection. Diversity indices and LEfSe analysis compared groups, and correlations linked microbiome diversity to psychological scores.
Who was studied?
The final analysis included 30 women with OAB and 25 asymptomatic controls in China. Five of the originally recruited controls were excluded for low read counts or suspected contaminants. Median age was 27.5 years for patients and 26.0 for controls, and most participants were premenopausal and currently married. OAB symptom scores were significantly higher in patients. Anxiety was present in 40 percent and depression in 47 percent of the OAB group, both markedly higher than in controls. Urine was collected between September 2016 and March 2017.
What were the most important findings?
The OAB urinary microbiome had lower bacterial richness and diversity than controls. Chao1 richness and the Simpson diversity index were both significantly lower in OAB (both p equals 0.038), while evenness did not differ. LEfSe analysis found 7 genera increased and 13 decreased in OAB versus controls. At the phylum level, Actinobacteria rose to 19.8 percent in OAB versus 6.8 percent in controls (p equals 0.048), driven by Bifidobacteriales. Within OAB patients, higher depression scores correlated inversely with both Shannon diversity (r equals -0.516, p equals 0.003) and Chao1 richness (r equals -0.458, p equals 0.011).
What are the greatest implications of this study?
The findings suggest an altered, less diverse urinary microbiome may be involved in OAB, and that some increased genera resemble organisms seen in urinary tract infection. This hints that low-grade infection undetected by standard culture could contribute to symptoms. Linking depression severity to reduced urinary bacterial diversity raises the possibility of a brain-bladder-microbiome axis. This could support combining microbiome and psychological status in patient phenotyping. The study is cross-sectional with a small sample, so it cannot establish cause and effect.