The role of the microbiome for the onset of urinary stone disease (USD) has received considerable attention in recent years, with numerous clinical metagenome-wide association studies (MWAS) published since 2016. While these studies have shown some significant associations between the microbiome and USD, details concerning the broader clinical associations with the microbiome, such as for sex or age, along with the specific bacteria responsible for associations have been inconsistent. In fact, the primary factor driving the results in each of the studies appeared to be the location where the study was conducted, which suggests the possibility that study-specific technical differences in the way samples were collected, stored, or processed, impacted the resulting microbiome data.
Recognizing the possibility that technical differences may impact the results of individual studies, study authors Drs. Naveen Kachroo and Aaron Miller sought out the investigators who previously published clinical MWAS for USD in order to come to a consensus on how these studies should be conducted and to develop standardized protocols that can be used by all investigators interested in conducting similar studies. These efforts led to an international consensus that produced protocols relating to the collection, storage, and processing of urine, kidney stone, and stool samples for microbiome analyses, along with a standardized analytical pipeline that can be employed for the rapid analysis of data combined with a real-time meta-analysis that incorporates all previously published MWAS data for USD. With these standardized protocols, Kachroo et al. hope to minimize the technical biases known to impact MWAS and to make this type of research much more broadly available to investigators interested in pursuing their own microbiome studies.
Written by: Aaron W. Miller, PhD, Departments of Urology and Cardiovascular & Metabolic Sciences, Cleveland Clinic Foundation, Cleveland, OH
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