Narrative review reveals that bacterial extracellular ATP triggers bladder signaling pathways, suggesting commensal microbiota could counter pathogen-driven urinary dysfunction.
The ability of uropathogenic bacteria to release excitatory compounds, such as ATP, may act as a virulence factor to stimulate signaling pathways that could have profound effects on the urothelium, perhaps extending to the vagina. This may be countered by the ability of certain commensal urinary microbiota constituents, such as lactobacilli. Further understanding of these interactions is important for the treatment and prevention of UUI and OAB. The clinical implications may require a more targeted approach to enhance the commensal bacteria and reduce ATP release by pathogens.
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Abbasian et al. (2019) studied this question.
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