In recent years, the intricate relationship between the human microbiome and host physiology has come into sharper focus, uncovering fascinating roles for commensal bacteria in health and disease. Among the most captivating revelations is the capacity of certain gut and urinary tract microbes to influence endocrine function by modulating steroid hormone levels. Now, groundbreaking research reveals an expanded and previously unappreciated microbial metabolic pathway responsible for androgen production, which directly impacts prostate cancer progression and therapeutic resistance.
Androgens such as testosterone and its derivatives play a pivotal role in regulating male physiology, influencing not only reproductive function but also the development and progression of diseases like prostate cancer. Traditional understanding has long centered on the host’s own adrenal glands and gonads as the primary sources of circulating androgens. However, a team led by Wang et al. has unearthed compelling evidence that commensal bacteria residing in the gut and urinary tract possess enzymatic arsenals capable of synthesizing and transforming androgenic steroids independently of the host.
Central to this discovery is the identification of a microbial gene in Clostridium scindens, a common gut microbiome constituent, that encodes an enzyme mediating the conversion of androstenedione, a primary androgen precursor, to epitestosterone. This gene, designated desF, catalyzes a biochemical reaction previously unattributed to bacterial metabolism within the human microbiome. The team’s meticulous genetic and enzymatic characterization of desF reveals a new layer of complexity in microbial steroidogenesis that may have profound implications.
Epitestosterone, though structurally similar to testosterone, has unique biological effects that are still being elucidated. The research highlights that this bacterial derivative can modulate androgen receptor-dependent prostate cancer cell proliferation in vitro, underscoring a direct mechanistic link between microbial steroid metabolism and host cellular behavior. This positions commensal bacteria not merely as passive inhabitants but as active biochemical participants in hormone-dependent pathologies.
Intriguingly, the researchers observed elevated stool levels of the desF gene in patients with prostate cancer who exhibited resistance to standard abiraterone and prednisone therapy. Abiraterone acts by inhibiting the host enzyme CYP17A1 (desmolase), a critical step in adrenal steroidogenesis, aiming to suppress systemic androgen synthesis. However, the bacterial enzymes, including desF’s product and a separate desmolase complex termed DesAB encoded by the microbiota, appear impervious to this pharmaceutical blockade. This microbial resistance mechanism may underlie persistent androgen receptor activation and tumor growth despite clinical intervention.
Expanding beyond the gut, the researchers isolated urinary and prostatectomy tissue bacteria capable of androgen production, notably Propionimicrobium lymphophilum, a urinary tract commensal. This organism harbors the desG gene encoding 17β-hydroxysteroid dehydrogenase activity, an essential enzyme in steroid metabolism. Its presence in urinary strains capable of converting prednisone and cortisol into androgens reveals a previously unrecognized microbial niche contributing to local and systemic steroid hormone pools.
These findings collectively reveal a covert microbial steroidogenetic machinery that can metabolize host-administered glucocorticoids like prednisone into potent androgens, promoting prostate cancer cell growth via androgen receptor pathways. This metabolic interplay profoundly challenges the dogma that endocrine interventions solely target human enzymes, illuminating a shadow endocrine network intricately woven by microbiota-host interactions.
Mechanistically, the bacterial desmolase complex DesAB appears functionally analogous but structurally distinct from its human counterpart CYP17A1, allowing selective pharmacological evasion. Alongside DesAB, the desF and desG enzymes constitute a sequential metabolic axis empowering microbiota to bypass host-targeted androgen biosynthesis suppression. This microbial steroidogenic pathway broadens the paradigm of hormone-driven cancer biology by incorporating commensal contributions to the tumor microenvironment.
Beyond oncology, these discoveries resonate with burgeoning evidence implicating microbiome involvement in drug metabolism and systemic hormone regulation. The revelation that commensals can modulate steroid availability and potentially shape therapeutic outcomes invites a re-examination of current treatment strategies for hormone-dependent diseases. Targeting these microbial pathways may represent a novel adjunctive therapeutic avenue.
Furthermore, the study accentuates the need for integrated analyses of patient microbiomes when evaluating hormone levels and drug resistance. Stool metagenomic quantification of desF and related genes could serve as biomarkers for disease progression or treatment responsiveness, enabling personalized medicine approaches that accommodate microbial contributions.
Looking forward, the interplay between microbial genes encoding steroid-metabolizing enzymes and host health suggests a multifaceted network where bacteria and human cells co-metabolize steroids with profound implications. This may extend beyond prostate cancer, influencing metabolic, immune, and neuroendocrine systems known to be sensitive to steroid hormones.
The identification of a functional bacterial desF gene and its enzymatic activity opens new investigative pathways into how bacterial metabolism intersects with human pathophysiology. Structural and biochemical studies of these enzymes could facilitate the development of microbiome-targeted inhibitors, potentially synergizing with current endocrine therapies to overcome resistance.
On a broader scale, these insights underscore the dynamic and reciprocal nature of the human-microbe relationship, where microbiota can exert endocrine functions traditionally ascribed solely to host organs. This redefines the microbiome as a quasi-endocrine organ with the capacity to influence systemic physiology profoundly.
Moreover, the discovery compels a reconsideration of drug development pipelines, highlighting the necessity of evaluating microbial drug targets and metabolic pathways that may contribute to therapeutic failure or adverse effects. This microbial perspective on xenobiotic metabolism enriches precision medicine’s landscape.
The study’s integration of advanced metagenomics, microbial genetics, and cell biology provides a compelling model for interrogating microbiota-host metabolic crosstalk. It also tempts future exploration into how dietary, environmental, and antibiotic interventions modulate this microbial steroidogenic capacity and affect disease trajectories.
In conclusion, Wang and colleagues have surmounted a critical knowledge gap by elucidating an expanded metabolic pathway for androgen synthesis on the microbial side of the human ecosystem. Their findings reveal that commensal bacteria possess a sophisticated steroidogenic toolkit capable of altering host androgen levels, fostering prostate cancer progression despite endocrine therapies. This landmark research paves the way for innovative approaches targeting microbiome-mediated steroid metabolism in cancer and beyond.
Subject of Research: Microbial metabolism of steroid hormones and its impact on androgen-dependent prostate cancer progression and therapeutic resistance.
Article Title: An expanded metabolic pathway for androgen production by commensal bacteria.
Article References:
Wang, T., Ahmad, S., Cruz-Lebrón, A. et al. An expanded metabolic pathway for androgen production by commensal bacteria.
Nat Microbiol (2025). https://doi.org/10.1038/s41564-025-01979-9
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