Роль уромікробіому в патогенезі раку сечового міхура (Огляд літератури)

Bladder cancer (BC) is the 9th most common cancer in the world that makes it 3% of the global neoplasms. BC is prevalent in the developed countries. BC is nearly 3.7 times more common in men than in women. External risk factors and internal triggers contribute to the development of BC. Thus, comprehensive analysis of these risk factors leads to timely prevention of indicated oncologic pathology. New approaches in understanding the role of urine microbiome allow us to correctly estimate bacterial spectrum changes from healthy individual to the patient with BC. This offers us new opportunities in receiving bacterial markers in diagnostics of BC and application perspective therapeutic options. Despite the fact that urinary microbiome is mainly similar to microbiome of healthy person, there are some differences in the urine microbiome between BC and various control groups. These distinctions include dominance of Howardella, Streptococcus, Sphingobacterium, Actinomyces, Achromobacter, Brevibacterium, Anaerococcus, Pseudomonas, Fusobacterium nucleatum and Ralstonia at the genus level, with prevalence of Cutibacterium, Proteobacteria, Firmicutes and Actinobacteria at the phylum level. Appropriate urinary microbiome may influence an extracellular matrix that promotes further tumor metastasis. The article is devoted to a review of literary sources on the role of urinary microbiome as a potential risk factor of BC. We conducted a systemic review of the role of the microbiome as a risk factor for the development of BC using PubMed, Embase аnd Scopus (up to August 2024). Histologically all patients suffered from the urothelial BC. We used both human and animal models. All studies that respond next criteria were included to our study: research that compared patients with BC and control group (case-controlled studies); clinical studies that used meta-analysis; studies which gave data with increased or decreased uropathogens in oncologic or control groups. Studies with insufficient data were excluded from our research. We analyzed a total of 214 papers that studied the role of microbiome in the epidemiology of BC. After deduplication, 128 studies were excluded from our work. 61 studies were included in our review after additional screening. According to GLOBOCAN, there were 573,000 new BC cases and 213,000 deaths worldwide in 2020. Smoking and occupational exposures (aromatic amines and polycyclic aromatic hydrocarbons) are the most common risk factors. Urinary microbiome is able to cause the BC. Cutibacterium, Proteobacteria, Firmicutes and Actinobacteria had prevalence at the genus level. Howardella, Streptococcus, Sphingobacterium, Actinomyces, Achromobacter, Brevibacterium, Anaerococcus and Pseudomonas were risk factor at the phylum level. Additional risk markers at the species (gene) level were Fusobacterium and Ralstonia. Thus, smoking tobacco and specific occupational exposures are the most important risk factors for BC. Urinary microbiome in the patients with BC may be the result of smoking exposure, pollution of external environment and diet. The presence of polycyclic aromatic hydrocarbons provides a specific metabolic niche and supports necessary metabolic resources for survival of appropriate bacterial genus, which inhibits the reproduction of other taxonomic units. But additional high-quality studies with useful 16S rRNA gene sequencing are required to confirm initial results that will support timely prevention and BC treatment.