Микробиом мочи: норма и патология

История изучения микробиома мочи насчитывает приблизительно 150 лет, и ранее считалось, что мочевая система здорового человека должна быть абсолютно стерильна. Лишь в последние несколько десятилетий мнение научного сообщества по этому вопросу радикально изменилось. Прогресс в области микробиологических исследований позволил применить расширенные культуральные и новейшие молекулярно-генетические методы для обнаружения и идентификации микроорганизмов, населяющих мочевые пути. Наконец, так прочно устоявшаяся догма о стерильности мочи здорового человека была разрушена. В моче были обнаружены не только бактерии, но также вирусы и грибы. Появилось понятие «уробиом». В настоящее время нет единого представления о том, какой состав микробиоты мочи следует считать нормальным, однако уже накоплены данные, позволяющие сделать вывод о том, что его изменения влияют на развитие различных урологических заболеваний не только в отрицательном, но и в положительном ключе, хотя многие патогенетические механизмы этих влияний еще не изучены. При этом состав уробиома может влиять на развитие не только воспалительных заболеваний, таких как инфекция мочевых путей, но и невоспалительных – доброкачественной гиперплазии предстательной железы, интерстициального цистита / синдрома болезненного мочевого пузыря, мочекаменной болезни, гиперактивного мочевого пузыря и недержания мочи, а также рака мочевого пузыря. В данной статье изложены методы и проблемы исследования микробиома мочи, представлена характеристика уробиома у здоровых людей и людей с некоторыми урологическими заболеваниями.

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