Microbiome and urolithiasis: New possibilities for prevention

The history of the scientific study of urolithiasis goes back many centuries. The treatment of urolithiasis has evolved from severe mutilating surgeries to modern minimally invasive procedures. Epidemiological data show that the global incidence rate of urolithiasis keeps steadily growing. Urolithiasis is endemic, which is determined by the influence of various modifiable factors, including socioeconomic and climatic factors. Statistics indicate that the incidence of urolithiasis in the Russian Federation has increased by 35.45% from 2005 to 2019, which necessitates the development of effective preventive measures. Preventive measures for urolithiasis are primarily based on lifestyle modification and pharmacotherapy. Current evidence supports the paradigm that the human microbiome constitutes a full-fledged organ, as changes in its qualitative and quantitative composition in different loci can have a significant impact on metabolism and immunity. Modern scientific research has established the mechanisms through which certain components of the urinary microbiome can both inhibit and stimulate lithogenesis. Studies have shown that the urinary tract microbiome of healthy people is dominated by commensal bacteria, such as Lactobacillus and Streptococcus, which maintain microenvironmental homeostasis. Patients with urolithiasis have a significantly reduced diversity of the intestinal and urinary microbiomes, as well as changes in single taxa community levels. Studying the urinary and intestinal microbiome establishes a bridgehead for the development of new approaches to urolithiasis prevention. This article presents data on the relationship between the urinary microbiome and urolithiasis, and describes prospects for developing a new approach to its treatment and prevention.

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