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  • The Role of the Urinary Microbiome in Prostate Cancer Progression: From Early Detection to Targeted Therapy

  • Melina Sadat Afsari,1 Sana Mahdian Rizi,2 Mahsa rafieipour,3 Mohammad Mahdi Elahiyan,4,*
    1. Medical Student, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
    2. Student Research Committee, Neyshabur University Of Medical Sciences, Neyshabur, Iran
    3. College Of Science, Faculty Of Biotechnology, University Of Tehran, Tehran, Iran
    4. Student Research Committee, School of Allied Medical Sciences, Iran University of medical sciences, Tehran, Iran


  • Introduction: Prostate cancer (PCa) is one of the most prevalent malignancies in men, with early detection and targeted therapy posing significant clinical challenges. Emerging evidence has challenged the notion of urine sterility, revealing a dynamic urinary microbiome whose dysbiosis may influence prostatic inflammation, carcinogenesis, and therapeutic response. Understanding microbial shifts associated with PCa could enable non-invasive diagnosis and novel treatment strategies.
  • Methods: This narrative review synthesized data from original research, systematic reviews, and meta-analyses published between 1999 and 2024. A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Google Scholar using keywords such as “urinary microbiome,” “prostate cancer,” “diagnosis,” and “treatment.” Inclusion criteria focused on peer-reviewed English-language studies examining the urinary microbiome’s diagnostic, pathogenic, and therapeutic implications in PCa. Quality was appraised using adapted PRISMA and AMSTAR guidelines.
  • Results: Distinct differences in microbial composition were identified between PCa patients and healthy individuals. Increased abundance of Cutibacterium acnes, Prevotella, and Peptoniphilus in PCa cases was associated with pro-inflammatory and tumor-promoting pathways, while taxa like Faecalibacterium prausnitzii were diminished, suggesting a loss of protective functions. Specific bacteria such as Propionimicrobium lymphophilum and anaerobic cocci were more prevalent in early-stage disease, whereas novel taxa such as Varibaculum prostatecancerukia appeared in advanced cases. Microbial biomarkers, including the Anaerobic Bacterial Biomarker Signature (ABBS), demonstrated potential for stratifying cancer risk and predicting disease progression. Functional analyses suggested microbial contributions to immune modulation, androgen metabolism, and oxidative stress.
  • Conclusion: The urinary microbiome exhibits stage-specific dysbiosis in prostate cancer and holds promise as a non-invasive biomarker for early detection and personalized therapy. Microbial profiling may augment current diagnostic algorithms, improve patient stratification, and inform microbiome-based interventions. However, standardized methodologies and longitudinal studies are essential to validate causality and clinical utility.
  • Keywords: Prosrat cancer, Urinary microbiome, Review

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