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

However, further research is warranted to identify In addition, tea has exhibited some kidney-protective
specific bacterial strains and mechanisms responsible for effects. 99,100
FMT’s efficacy in HUA management. Large-scale clinical In a HUA mouse model induced by continuous
trials are crucial to assess the long-term safety and efficacy potassium oxonate administration, black brick tea with
of FMT and other gut microbiota-targeted therapies for high levels of theaflavins displayed superior efficacy in
HUA. Advancements in technology, such as precision reducing SUA levels compared to traditional black tea.
FMT and personalized probiotic/prebiotic formulations, Green tea polyphenols have been found to lower UA levels
could further improve the effectiveness of gut microbiota- by inhibiting UA generation and stimulating UA excretion.
targeted HUA therapies. Due to the distinct processing methods, green tea and black

In summary, FMT and other gut microbiota-targeted tea extracts demonstrate varying degrees of effectiveness
strategies offer promising avenues for HUA management, in reducing HUA. Particularly, black tea extracts tend to
potentially providing safer and more effective alternatives be more effective than green tea extracts in reducing SUA
to traditional treatments. levels, displaying a significant dose-dependent effect.
A meta-analysis of long-term randomized controlled trials
5.4. Nutrients revealed that tea or tea extracts can lower SUA levels in
Nutrients are essential substances for maintaining human asymptomatic HUA patients by regulating XO excretion
physiological functions. Studies have demonstrated that and urate-specific proteins. 101-103
beneficial microbes, such as Bifidobacteria and Lactobacilli, Despite the promising applications and development
within the gut microbiota can help lower UA levels through prospects of tea and its functional components in lowering
various mechanisms. First, they can synthesize basic UA, challenges remain. The research on the mechanism,
supplements, such as folic acid and Vitamin B, which are pathway, and target of tea’s urate-lowering effect is not
vital for maintaining overall health. In addition, they can yet comprehensive enough. Further studies are needed to
inhibit XO, an enzyme responsible for converting purines determine whether tea can be utilized for the treatment
into UA, thereby reducing UA production. Moreover, of HUA.
they can regulate UA transporters in the gut, facilitating
its excretion and preventing its accumulation in the 5.4.3. Vitamins
blood. Therefore, nutrient supplementation may be a safe Vitamins are essential organic compounds required for
and viable approach for the prevention and treatment of the maintenance of normal physiological function within
HUA. 95-97 the body. They can be classified into two categories:

5.4.1. Protein diets Fat-soluble and water-soluble vitamins. These vitamins
play a significant and imperative part in human growth,
The Third National Wellbeing and Nourishment Study metabolism, and development. Increasing evidence
revealed people who consumed milk once or more per suggests that vitamins have a substantial impact on
day had lower SUA levels compared to those who did intestinal microbiota composition. They can either enhance
not drink milk (multivariate contrast: −0.25 [95% CI: or maintain the diversity and abundance of the intestinal
−0.40, −0.09]; p < 0.001). In a short-term randomized microbiota, regulate the intestinal immune response or
controlled trial of 16 male volunteers, the ingestion of barrier function, and play a crucial part in maintaining
all types of milk resulted in a decrease in serum urate intestinal homeostasis and the balance between the host
concentrations by approximately 10% (p < 0.0001). The and gut microbiota. 104-106
mechanism by which protein diets can lower SUA levels
may involve glycomacropeptide and G600 milk fat extract, Combining probiotics with vitamins can enhance the
both of which inhibit IL-1β gene and protein expression. beneficial effects of probiotics. By improving gut microbial
From a urate-lowering and possibly anti-inflammatory populations, vitamins can increase mucus secretion, which
perspective, protein diets may offer protection against helps to prevent the breakdown of tight junction proteins
106
gout. 97,98 and maintain the integrity of the gut barrier.
In addition, vitamins can reduce the concentration
5.4.2. Tea and tea extracts of LPS, which are harmful bacterial components that
Tea, a healthy beverage with numerous benefits, has can trigger inflammation and compromise gut barrier
displayed the potential to alleviate HUA through various function. Several key vitamins are essential for
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mechanisms. Studies have demonstrated that tea and its maintaining a healthy intestinal barrier and optimal
extracts can reduce SUA levels by inhibiting XO, regulating immune homeostasis. The incorporation of these vitamins
urate-specific proteins, and modulating the gut microbiota. into diets and using probiotics can help maintain a healthy

Volume 9 Issue 2 (2025) 68 doi: 10.36922/ejmo.8579