Causal Relationship Between Gut Microbiota and Benign Prostatic Hyperplasia: A Two-Sample Mendelian Randomization...

Area of Science:

• Microbiology
• Urology
• Genetics

Background:

• Emerging evidence suggests a connection between gut microbiota (GM) and benign prostatic hyperplasia (BPH).
• The precise causal relationship between GM and BPH remains unclear, necessitating further investigation.

Purpose of the Study:

• To investigate the potential causal associations between gut microbiota and benign prostatic hyperplasia using Mendelian randomization (MR).
• To explore the role of specific gut bacteria in the severity of lower urinary tract symptoms (LUTS) associated with BPH.

Main Methods:

• A two-sample Mendelian randomization (MR) analysis was performed using genome-wide association study data.
• 16S rRNA sequencing was used to analyze fecal samples from BPH patients and healthy controls.
• Statistical methods included inverse variance-weighted (IVW), weighted median (WM), and MR-Egger analyses, alongside heterogeneity and pleiotropy assessments.

Main Results:

• MR analysis indicated that *Phascolarctobacterium*, *Faecalibacterium*, and *Escherichia-Shigella* were associated with increased BPH risk, while *Lactobacillus* and *Burkholderia* showed protective effects.
• *Escherichia-Shigella* was consistently associated with BPH risk across methods and showed increased abundance in BPH patients.
• Higher relative abundance of *Escherichia-Shigella* independently predicted severe LUTS and demonstrated significant predictive value for LUTS severity (AUC=0.777).

Conclusions:

• The study provides evidence supporting a potential causal role of gut microbiota in the development of benign prostatic hyperplasia.
• *Escherichia-Shigella* emerges as a significant bacterial predictor of lower urinary tract symptom severity in BPH.
• These findings may inform future therapeutic strategies targeting microbial dysbiosis for BPH management.