MP36-01 THE URINARY MICROBIOME DIFFERS SIGNIFICANTLY BETWEEN PATIENTS WITH CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME AND CONTROLS AS WELL AS BETWEEN PATIENTS WITH DIFFERENT CLINICAL PHENOTYPES

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INTRODUCTION AND OBJECTIVES: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a common disorder with heterogeneous etiologies and clinical features.There are currently no validated biomarkers.Several studies of the urinary microbiome have failed to find consistent differences between patients and controls and between different CP/CPPS phenotypes.METHODS: We identified 25 CP/CPPS patients (NIH category III definition) seen in clinic and 25 men who were either asymptomatic or only had Lower Urinary Tract Symptoms but no pain.Mid-stream urine was collected and stored on ice.Symptom severity was measured with the NIH-Chronic Prostatitis Symptom Index (CPSI) and clinical phenotype with UPOINT.Total DNA was extracted from the pellet of the collected urine from cases and controls.MiSeq-sequencing of bacterialspecific 16S-rDNA-capture was performed.Taxonomic and functional bioinformatic analyses were performed using principal coordinate analysis (PCoA), QIIME, LEfSe, and PiCRUSt algorithms RESULTS: There were 25 patients and 24 controls with evaluable data.Mean ages were similar (CP/CPPS 52.3 vs control 57.0 years, p¼0.27).For patients, median duration was 48 months, mean CPSI was 26.0 and mean number of UPOINT domains was 3.6.Weighted 3D Unifrac PCoA revealed tighter clustering of controls in a space distinct from the wider clustering of cases (corrected P¼0.001; adiversity P¼0.006).Compared to controls, 49 operational taxonomic units (OTU) were over-represented in patients, eg, Clostridia, and 18 under-represented, eg, Eichenella, resulting in predicted perturbations in functional pathways.Microbiomic differences were noted for symptom severity (CPSI < or > 26), duration (< or > 48 months), total positive UPOINT domains and presence of specific Psychosocial and Neurologic/Systemic domains (p¼0.001-0.003).These associations were predicted to result in perturbations of several pathways, such as indole alkaloid synthesis, and flavone/flavonoid synthesis pathways CONCLUSIONS: CP/CPPS patients have significantly higher alpha diversity of the urinary microbiome which cluster differently from controls, and higher counts of Clostridia compared with controls, with separation sufficient to serve as a potential biomarker.Significant microbiome differences occur with several clinical measures of severity and clinical phenotype resulting in predictive perturbations of functional pathways which could suggest metabolite-specific targeted treatment

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