Page 74 - EJMO-9-2

Eurasian Journal of
Medicine and Oncology Gut microbiota and hyperuricemia: Mechanisms and therapeutic strategies

metabolism, endocrine, and immune systems. Consequently, hypoxanthine and intraperitoneal injection of potassium
probiotics, prebiotics, nutrients, and FMT offer a relatively oxalate by oral gavage, L. rhamnosus R31, L. rhamnosus
safe and effective approach to managing HUA (Table 2). R28-1, and Lactobacillus lucidus L20M3 effectively reduced
the concentration of UA in serum and urine, as well as the
5.1. Probiotics activity level of XOD in serum and liver tissue. They also
A probiotic is defined by the Food and Agriculture promoted the production of SCFAs, reversed the rise of
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Organization and World Health Organization as live LPS, and alleviated liver and kidney injury. L. fermentans
microorganisms that, when administered in adequate F40-4 can remodel intestinal microbiota and inhibit
amounts, offer a health benefit to the host. Its functions inflammation to improve HUA, as it was reported to
include maintaining the stability and diversity of the human reduce SUA, blood urea nitrogen, creatinine, and XO levels
gut microbiota, regulating the expression of host genes, by 40.84%, 11.61%, 57.66%, and 41.79%, respectively.
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modulating immune responses, producing antibacterial Oral administration of Lactobacillus paracasei X11
substances, and releasing functional proteins. Due to its reportedly reduced SUA by 52.45% and inhibited renal
many health benefits, probiotics are considered a promising pro-inflammatory cytokine IL-1β by 50.69%, as well as
natural therapy. Strains of Lactobacillus, Bifidobacterium, regulated the expression of adenosine deaminase (ADA),
and Saccharomyces have a long history of safe and effective XOD, and various transporters (GLUT9, NPT1, and
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use as probiotics. Regular administration of Lactobacillus URAT1) to normal levels. The study found that L. gasseri
salivarius CECT 30632 (L. salivarius CECT 30632) can PA-3 can improve the UA level of patients with borderline
reduce the serum urate level, reduce the number of gout HUA. For patients with HUA and gout, Lactobacillus reuteri
attacks, and can be used as a drug to control HUA and gout TSR332 and Lactobacillus fermentans TSF331 strains are
attacks. Probiotic LPN1 can prevent Ethylene glycol (EG)- potential functional probiotics strains for controlling
induced hyperoxaluria by regulating the gut microbiota the development of HUA. Notably, the UA level in the
and enhancing intestinal barrier function. In a HUA rat treatment group of Lactobacillus reuteri TSR332 decreased
model induced by oral potassium oxyacetate combined more significantly compared to the placebo group, and no
with a high purine diet, Lactobacillus rhamnosus 1155 obvious side effects were observed in TSR332. In a HUA
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(LR1155) and Lactobacillus fermentans 2644 (LF2644) mouse model induced by hypoxanthine and potassium
inhibit the activity of XO, upregulate ABCG2, and reduce oxybate, chlorogenic acid supplementation not only
LPS and inflammatory indicators. Oral administration increased the production of SCFA in the feces of HUA
of LR1155 and LF2644 or a combination significantly mice but also increased the relative abundance of bacteria
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reduced SUA levels after 4 weeks. In a mouse model with producing SCFA, including Bacteroides, Prevoteaceae
Table 2. Treatment of hyperuricemia based on intestinal flora

Treatment Attribution Mechanism Shortcomings
Probiotic Live microorganisms Maintaining the stability and diversity The research is still in its early stages,
of human gut microbiota, regulating and there is still limited understanding
host gene expression, regulating of its relief mechanism; the safety and
immune response, producing effectiveness of clinical use still need to be
antibacterial substances, and releasing verified
functional proteins
Prebiotic A selectively fermented Changing bacterial composition and
ingredient short-chain fatty acids
FMT Functional gut microbiota Improve the structure of intestinal Long-term follow-up should be conducted
transferred from healthy microbiota, increase the abundance to monitor clinical efficacy and long-term
human feces to the patient’s of beneficial bacteria, inhibit the adverse reactions
gastrointestinal tract growth of pathogenic bacteria, and
increase intestinal anti-inflammatory
metabolites
Nutrients Essential substances Inhibit xanthine oxidase, regulate uric The observation period is relatively
for maintaining human acid transporter, inhibit oxidative short, and more research is needed to
physiological functions, stress, and reduce inflammation prove its impact pathways and targets;
including dairy products, the dosage range and long-term safety
tea with tea extracts, and recommendations still need to be improved
vitamins
Abbreviation: FMT: Fecal microbiota transplantation.

Volume 9 Issue 2 (2025) 66 doi: 10.36922/ejmo.8579