REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
This article is part of the Research TopicMicrobiota-Immune Interactions: A New Frontier in Cancer Treatment OptimizationView all 11 articles
The Infection–Microbiome–Immunity Axis in Bladder Cancer: Mechanistic Insights and Therapeutic Perspectives
Provisionally accepted
- 1Department of Nuclear Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- 2Department of Microbiology and Immunology, Keio Gijuku Daigaku, Minato, Japan
- 3Department of pediatrics, The First Hospital of China Medical University, Shenyang, China
- 4Department of Urology, ShengJing Hospital of China Medical University, Shenyang, China
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Bladder cancer (BC) represents a paradigm of infection-associated malignancy in which microbial dysbiosis, immune aging, and tumor microenvironmental remodeling converge to shape disease progression. Increasing evidence highlights the dual role of the urinary and gut microbiota in modulating bladder carcinogenesis through infection-driven inflammation and immune dysfunction. Chronic exposure to uropathogens and microbial imbalance disrupts epithelial integrity, promotes extracellular matrix degradation, and reprograms local immune signaling, collectively fostering a tumor-permissive niche. Concurrently, immunosenescence exacerbates microbial persistence and impairs antitumor immunity, reinforcing a pathogenic feedback loop between infection and immune decline. This review integrates current insights from microbiome research, tumor immunology, and microbial pathogenesis to delineate the mechanistic continuum linking infection, dysbiosis, and immune remodeling in BC. Finally, we discuss emerging microbiome-targeted and immunomodulatory strategies aimed at restoring microbial–immune equilibrium and improving therapeutic efficacy. Together, these perspectives provide a refined conceptual framework for understanding infection-driven oncogenesis and guiding precision interventions in BC.
Keywords: Bladder cancer, immunosenescence, Inflammation, microbiome, Urinary Tract Infections
Received: 30 Sep 2025; Accepted: 16 Dec 2025.
Copyright: © 2025 Pan, Wang, Cui and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wanlin Cui
Bitian Liu
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