Page 75 - EJMO-9-2

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

UGC-001, and Butyromonas, which improved HUA and At present, an increasing number of studies are
regulated intestinal homeostasis. investigating the role and mechanisms of probiotics and
prebiotics in reducing UA. However, it is undeniable
5.2. Prebiotics that research on the therapeutic effects of probiotics

Prebiotics exert beneficial effects on the host’s intestinal and prebiotics on HUA is still in its early stages, and the
health, primarily by altering bacterial composition and understanding of their underlying mechanisms remains
SCFAs, including resistance to irritation, improvement of limited. Therefore, their safety and effect on clinical
the intestinal boundary, and changes in the gastrointestinal applications require further verification. More research
microbiota. Prebiotics were first defined in 1995 as and transformation work on probiotics and prebiotics
substances that specifically promote the growth and/ should be encouraged to facilitate their widespread use in
or migration of one or a limited number of bacteria treatment as soon as possible.
in the colon, thereby exerting beneficial effects on the
body to improve the health of the host. Based on this 5.3. FMT
description, only a few compounds in the carbohydrate FMT has emerged as a promising technique with diverse
group are considered prebiotics, including beta- applications. Initially, FMT entails transferring functional
fructans (fructooligosaccharides and inulin), galacto- gut bacteria from healthy donors to patients, aiming
oligosaccharides, and lactulose. When prebiotics were to restore microbial balance and improve gut function,
first defined, they had very specific effects on the human thereby offering a potential solution for HUA management.
intestinal microbiota, mainly manifested by increasing Xie et al. demonstrated that the administration of washed
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the populations of bifidobacteria and lactobacilli while microbiota transplantation substantially reduced SUA
reducing the cell numbers of Bacteroidetes, Clostridium, concentrations, alleviated the manifestations of gout, and
and Fusobacteria. At a meeting of the International restored the integrity of the intestinal barrier in individuals
Scientific Association of Probiotics and Prebiotics, the suffering from gout.
definition of the term “dietary prebiotic” was updated to “a
specific senolytic ingredient that induces specific changes The efficacy of FMT is hypothesized to be contingent
in the composition and/or activity of the gastrointestinal upon the reconstitution of a well-balanced microbial
microbiota that are beneficial to host health.” Bindels community within the gut, a process deemed essential
et al. 81,82 proposed a broader definition, in which prebiotics for the therapeutic success of the procedure. However,
are defined as non-digestible compounds that balance the the precise mechanisms underlying FMT remain partially
composition and/or activity of the intestinal microbiota obscured. In the context of HUA, the mechanism of action
through metabolism by intestinal microorganisms, of FMT encompasses several pivotal elements. Initially,
thereby producing beneficial physiological effects on FMT promotes an increase in commensal bacteria while
the body. At present, prebiotics are mainly composed of reducing pathogenic strains, thereby enhancing gut health
carbohydrates, but other substances, such as polyphenols and mitigating inflammation – a response of particular
and polyunsaturated fatty acids, may also play a role in significance given the chronic inflammatory nature often
prebiotics. 83 associated with HUA. Furthermore, FMT may augment the
functionality of UA transporters, such as ABCG2, within
Inulin is a type of fermentable dietary fiber. Within the intestinal tract, thereby facilitating the excretion of UA
the HUA mouse established by knocking out the Uox and reducing its serum concentration. Finally, FMT has
(UA oxidase) gene, inulin supplements can reduce the the potential to regulate the immune system, inhibiting the
expression and activity of liver XOD by increasing the secretion of pro-inflammatory cytokines and subsequently
intestinal microbial diversity and the expression of ABCG2 alleviating chronic inflammation linked to HUA. 87-93
in the gut. It also promotes SCFAs-producing bacteria (e.g.,
Akkermania and Ruminococcus) and safely and effectively FMT holds promise for HUA management, with
alleviates HUA. Fish meat oligopeptides (TMOP) can studies demonstrating reduced UA levels and improved
alleviate HUA and renal provocative phenotypes, repair symptoms in animal models and humans. For instance,
intestinal epithelial obstruction, restore intestinal whole-microbial transplantation, a modified form of FMT,
microbiota homeostasis, and increase the production of has demonstrated the potential to reduce UA levels and
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SCFAs. In HUA rats, mangiferin reduced serum urate improve gout symptoms. In addition, goose carnosine, a
levels and increased UA levels and UA excretion division naturally occurring compound, can restore gut microbiota
(FEUA), which may be related to repressing the mRNA balance, repair the intestinal barrier, and promote UA
and protein expression of URAT1, OAT10, and GLUT9 excretion, further supporting the role of FMT in HUA
within the kidney of hyperuricemic rats. 82-85 management. 94,95

Volume 9 Issue 2 (2025) 67 doi: 10.36922/ejmo.8579