Elucidating the role of gut microbiota dysbiosis in hyperuricemia and gout: Insights and therapeutic strategies

Abstract

Hyperuricemia (HUA) is a condition associated with a high concentration of uric acid (UA) in the bloodstream and can cause gout and chronic kidney disease. The gut microbiota of patients with gout and HUA is significantly altered compared to that of healthy people. This article focused on the complex interconnection between alterations in the gut microbiota and the development of this disorder. Some studies have suggested that changes in the composition, diversity, and activity of microbes play a key role in establishing and progressing HUA and gout pathogenesis. Therefore, we discussed how the gut microbiota contributes to HUA through purine metabolism, UA excretion, and intestinal inflammatory responses. We examined specific changes in the composition of the gut microbiota associated with gout and HUA, highlighting key bacterial taxa and the metabolic pathways involved. Additionally, we discussed the effect of conventional gout treatments on the gut microbiota composition, along with emerging therapeutic approaches that target the gut microbiome, such as the use of probiotics and prebiotics. We also provided insights into a study regarding the gut microbiota as a possible novel therapeutic intervention for gout treatment and dysbiosis-related diagnosis.

Keywords: Gut microbiota; Dysbiosis; Gout; Hyperuricemia; Inflammation; Intestinal barrier; Probiotics; Prebiotics; Fecal microbiota transplantation

Core Tip: Current research highlights the relationship between gout and gut microbiota composition. Gout patients have significantly different microbial profiles than healthy individuals, with changes in specific bacterial taxa. These alterations may increase uric acid production and purine metabolism, potentially worsening the disease. Traditional gout treatments influence gut microbiota while emerging approaches aim to rebalance the gut ecosystem using probiotics and prebiotics. This gut-centric view offers a novel perspective for developing new gout management strategies. Microbiome-focused treatments show promise, emphasizing the vital role of gut health in managing this metabolic condition and revealing new treatment opportunities.