human urinary tract metagenome Metagenome

Overactive bladder, a condition marked by urinary urgency, frequency, and incontinence, affects approximately 5-12% of children worldwide, with its peak prevalence occurring between the ages of 5 and 7 years . Beyond its clinical burden, OAB significantly impacts quality of life, contributing to social withdrawal and psychological distress in affected children. Traditionally, the pathophysiology of OAB has been attributed to neurological and developmental factors, including bladder overactivity and sensory dysfunction. However, accumulating evidence suggests that dysbiosis of the urinary microbiota may also contribute to bladder dysfunction, potentially modulating bladder inflammation and sensory signaling even in the absence of urinary tract infections . While the urinary tract was once considered sterile, recent advances in microbiome research, particularly through techniques like 16S rRNA gene sequencing and expanded quantitative urine culture, have revealed that the urinary tract hosts diverse microbial populations . These commensal and transient microbes are hypothesized to modulate host immunity, maintain epithelial barrier integrity, and interact with afferent nerves, potentially influencing OAB symptom onset and progression.This investigation pursued three aims: (1) to characterize structural and functional variations distinguishing overactive bladder (OAB) microbiota from healthy controls (primary focus); (2) to quantify relationships between microbial community features and clinical markers including symptom intensity, nocturnal urine loss, and post-void residuals; and (3) to explore mechanistic pathways connecting microbial metabolic functions with bladder pathophysiology. By integrating multi-dimensional data, this study provides novel insights into how urinary dysbiosis may perpetuate pediatric OAB, offering a foundation for microbiome-targeted diagnostics and therapies.