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REVIEW ARTICLE

Gut microbiota and hyperuricemia: From mechanisms to therapeutic strategies

Xiaojie Lu1,2 ,  Yuetong Zhao1,2 ,  Shuang Wu1,2 ,  Yunze Xing1,2 ,  Yaxuan Fang1,2 ,  Haitao Xing1,2 ,  Ming Pei1,2 ,  Jie Li1,2 ,  Yanheng Qiao1,2 ,  Yongming Tian1,2 ,  Bo Yang1,2*
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1 Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
2 Department of Nephrology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
EJMO, 8579 https://doi.org/10.36922/ejmo.8579
Submitted: 17 January 2025 | Revised: 16 February 2025 | Accepted: 6 March 2025 | Published: 25 March 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Hyperuricemia (HUA), a condition characterized by elevated levels of uric acid (UA) in the bloodstream, is intricately connected to an imbalance in the gut microbiota. UA, a byproduct of purine metabolism, serves as a crucial endogenous antioxidant. Recent research indicates that modifying the gut microbiome offers a promising avenue for managing HUA. This work delves into the complex relationship between HUA and changes in the gut microbiota, examining its impact on UA excretion, reabsorption, and the activity of enzymes involved in purine breakdown. Elucidating the precise mechanisms behind this connection is essential for developing effective treatments, and exploring various therapeutic approaches, including probiotics, prebiotics, dietary interventions, and fecal microbiota transplantation, which target the gut microbiota to reduce UA levels. These treatments may exert their effects through diverse pathways, such as inhibiting key enzymes, regulating UA transporters, reducing oxidative stress and inflammation, and restoring the balance of the gut microbiome. Furthermore, maintaining a healthy gut barrier is a valuable complementary therapy. This review aims to provide insights into the potential of gut microbiota manipulation as a novel and promising strategy for managing HUA. While this approach holds great promise, it is important to consider the potential risks and challenges associated with gut microbiota manipulation, and further research and clinical trials are warranted to fully understand its efficacy and safety.

Graphical abstract
Keywords
Hyperuricemia
Intestinal flora
Uric acid metabolism
Probiotics
Nutritional interventions
Funding
This study was supported by the National Natural Science Foundation of China (grant number: 81973799).
Conflict of interest
The authors declare that there are no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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