ISSN: 0973-7510

E-ISSN: 2581-690X

Research Article | Open Access
Ahmed Kabrah
Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, 24381, Saudi Arabia.
Article Number: 11787 | © The Author(s). 2026
J Pure Appl Microbiol. 2026;20(3):2202-2213. https://doi.org/10.22207/JPAM.20.3.11
Received: 12 May 2026 | Accepted: 25 June 2026 | Published online: 01 August 2026
Issue online: September 2026
Abstract

Bladder urothelial carcinoma (BLCA) is a molecularly heterogeneous malignancy with substantial unmet needs in risk stratification and therapeutic optimization. While the urinary microbiome has emerged as a critical modulator of cancer biology, its systems-level integration with host genomic, transcriptomic, and immune multi-omics data remains poorly characterized. We performed an integrative in silico analysis of 412 muscle-invasive bladder cancers from The Cancer Genome Atlas (TCGA-BLCA), combining curated microbial abundance profiles with host transcriptomic, epigenomic, mutational, immune deconvolution, and clinical survival data. Differential abundance analysis, Spearman correlation networks, Gene Set Enrichment Analysis, and machine-learning-based prognostic modeling were employed to identify microbe-host interaction landscapes and evaluate clinical translational potential. We identified profound microbial dysbiosis in tumor tissues, with Paenibacillus (31.1-fold enrichment, P = 2.56 × 10-6) and Prevotella (19.0-fold enrichment, P = 2.60 × 10-3) dominating the tumor microenvironment, while commensal genera, including Lactobacillus, Arthrobacter, and Gemella, were significantly depleted. Paenibacillus exhibited strong negative correlations with oncogenic drivers MYC (Spearman Correlation Coefficient (SCC) = -0.506), ESR1 (SCC = -0.491), and AR (SCC = -0.458), suggesting tumor-suppressive mechanisms through metabolic and immune modulation. Conversely, Prevotella demonstrated bidirectional modulation of host genes, implicating pro-inflammatory and epithelial-mesenchymal transition pathways. Multi-omics integration revealed that microbial signatures stratified TCGA molecular subtypes, immune phenotypes, and clinical outcomes. A microbiome-informed prognostic model achieved superior predictive accuracy (AUC = 0.847) compared to clinical variables alone, with validation across four independent cohorts (combined HR = 0.65, 95% CI: 0.52-0.81, P < 0.001). This study establishes a comprehensive framework for microbiome-host interactions in BLCA, identifying Paenibacillus and Prevotella as opposing microbial orchestrators of tumor biology. These findings advance bladder cancer microbiome research from descriptive taxonomy toward the development of mechanistic, clinically actionable biomarkers for precision oncology.

Keywords

Bladder Cancer, Microbiome, Multi-omics, TCGA, Biomarker, Tumor Microenvironment, Precision Oncology

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© The Author(s) 2026. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.