Patients with chronic pelvic pain syndrome have significantly lower gut microbiome diversity which cluster differently from controls. - GreenMedInfo Summary

INTRODUCTION: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CPPS) is a common disorder with heterogeneous etiologies and clinical features. The gut microbiome is a metabolically active ecosystem linked to systemic conditions (gut-brain axis). We hypothesize that the gut microbiome will show alterations between CPPS patients and controls METHODS: We identified CPPS patients and controls who were asymptomatic or only had Urinary Tract Symptoms. After rectal exam, the soiled glove tip was immersed in sterile saline and stored on ice. Symptom severity was measured with the NIH-Chronic Prostatitis Symptom Index (CPSI) and clinical phenotype with UPOINT. Total DNA was extracted from the pellet of samples. MiSeq-sequencing of bacterial-specific 16S-rRNA-capture was performed. Taxonomic and bioinformatic analyses were performed using principal coordinate analysis (PCoA), QIIME and LEfSe algorithms RESULTS: There were 25 patients and 25 controls with complete data. Mean ages were similar (CPPS 52.3 vs control 57.0 years, P=0.27). For CPPS-patients, median symptom duration was 48 months, mean CPSI was 26.0 and mean UPOINT domains was 3.6. 3D Unifrac PCoA revealed tighter clustering of controls in a space distinct from the wider clustering of cases (P=0.001); with cases having decreasedα-diversity (P=0.001). Compared to controls, 3 taxa were over-represented in cases, and 12 under-represented, eg, Prevotella.

CONCLUSIONS: CPPS patients have significantly lower gut microbiome diversity which cluster differently from controls, and robustly lower counts of Prevotella, with separation sufficient to serve as a potential biomarker. The gut microbiome may serve as both disease biomarker and potential therapeutic target in CPPS.