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

that each additional mg/dL of UA was associated with a between HUA and the intestinal environment. The
74.25 nmol/L decrease in serum 25-hydroxyvitamin D mechanisms through which the intestinal microbiota can
levels, with results remaining consistent in sensitivity lower UA levels primarily involve inhibiting key proteins
analysis. 118,119 involved in UA regulation, modulating the expression
Dietary Vitamin E intake has also been reported to be of UA transporters, and restoring the integrity of the
inversely related to HUA in American adults, especially intestinal barrier. These actions collectively contribute to
in men and individuals aged 60 years or older. Vitamin the reduction of UA, providing a foundation for exploring
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E acts as a scavenger of hydroxyl, peroxy, and superoxide the potential of the intestinal microbiota in alleviating
radicals, protecting the body from the harmful effects of free HUA and supporting the development of novel therapeutic
radicals. It can also inhibit XO activity, thereby lowering approaches. Manipulating the intestinal microbiota –
UA levels. Furthermore, studies have demonstrated through probiotics, prebiotics, targeted nutrients, and
that Vitamin E can interfere with bacterial biofilms and FMT – represents a safe, cost-effective, and promising
prevent biofilm formation in vitro. Moreover, Vitamin E strategy for preventing elevated SUA levels, with significant
application has been demonstrated to reduce the ability of implications for both clinical practice and public health.
Staphylococcus aureus and Staphylococcus epidermidis to However, the intestinal microbiota operates within a
colonize surfaces. 120-123 complex and dynamic microenvironment influenced by
numerous factors. Precisely controlling UA metabolism
While the potential benefits of vitamin supplementation
in HUA management are promising, further research through the synergistic action of multiple mechanisms
is warranted to clarify the precise mechanisms, optimal poses a considerable challenge. While the current research
dosages, and long-term safety profiles. Larger-scale clinical landscape is abundant with animal studies, clinical trial
trials with longer durations of observation are essential to data remains limited. Larger and more rigorous clinical
establish the efficacy and safety of vitamin supplementation investigations are necessary to bridge the knowledge gap
as a potential therapeutic approach for HUA. regarding the role of the intestinal microbiota in metabolic
diseases, including HUA, and to elucidate their specific
6. Discussion mechanisms. In addition, clinical studies are needed to verify
the practicality and safety of therapies based on intestinal
Genetic mutations in the uricase gene that increase human microbiota regulation for HUA. In the pursuit of therapeutic
susceptibility to HUA lead to elevated UA levels. In mice efficacy, it is essential not only to focus on the immediate
with uricase deficiency, the removal of the microbiota effects of interventions but also to consider potential adverse
results in a profound state of HUA. In addition, clinical reactions and long-term outcomes. Translating basic
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observations have correlated the administration of theoretical insights into clinical practice represents a key
antibiotics that target anaerobic bacteria in humans with direction for future research endeavors. 58,61,128,129
a heightened risk of developing gout. These findings
underscore the therapeutic potential of microbiome- 7. Conclusion
targeted interventions for the treatment of HUA.
The complex relationship between the gut and HUA
The increasing prevalence of HUA necessitates the highlights the intricate role of the gut as both a digestive
development of safe and effective treatment strategies. and detoxifying organ. In this context, the gut microbiota
Current HUA treatments provide rapid symptom relief but develops into a complex environment with significant
come with risks, including allergic reactions and systemic impacts on metabolic patterns. The interplay between the
damage. The intestine emerges as a critical alternative gut microbiota and the UA metabolic system suggests a
route for UA elimination. Elevated UA levels can bidirectional relationship, where the uncoordinated nature
compromise the intestinal barrier, induce oxidative stress, of the gut microbiota may contribute to the development
exacerbate inflammation, and dysregulate UA metabolism. of HUA. This understanding highlights the potential of
Understanding the gut microbiota’s role in UA metabolism manipulating the gut microbiota as a novel and promising
is crucial for HUA diagnosis and treatment. 124-126 therapeutic approach for managing HUA. This approach

In the context of cancer, research suggests that may open new avenues for the development of innovative
UA-derived nucleotides within the intestinal environment drugs, providing an exciting perspective to treating this
can promote the growth of colorectal cancer cells, metabolic disorder.
subsequently enhancing the tumor’s resistance to
both chemotherapy and radiation treatments. This Acknowledgments
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comprehensive work underscores the complex interplay None.

Volume 9 Issue 2 (2025) 70 doi: 10.36922/ejmo.8579