Gout, Hyperuricemia, and the Intestinal Microbiome.

Area of Science:

• Microbiome Research
• Gout Pathophysiology
• Nutritional Therapeutics

Background:

• Gout is characterized by hyperuricemia (HU) and monosodium urate crystal deposition, leading to joint inflammation and damage.
• Emerging research focuses on the gut microbiome's role in HU and gout, exploring prebiotics and probiotics for therapeutic potential.

Purpose of the Study:

• To review recent studies on the gut microbiome in hyperuricemia and gout.
• To evaluate the efficacy of prebiotics and probiotics in managing gout and associated hyperuricemia.

Main Methods:

• Review of recent scientific literature on gut microbiome alterations in gout patients.
• Analysis of pre-clinical studies investigating probiotic and prebiotic interventions in animal models of gout.
• Examination of short-chain fatty acid (butyrate) effects on uric acid levels and inflammation.

Main Results:

• The 'gouty' microbiome exhibits reduced diversity, an increased Bacteroides: Firmicutes ratio, and lower levels of Akkermansia and Bifidobacterium.
• Lactobacillus probiotics reduced serum urate (SU) and inflammation in avian models.
• Inulin (prebiotic) and butyrate (short-chain fatty acid) showed potential in murine models to lower SU and reduce inflammation.

Conclusions:

• Gut microbiome modulation represents a potential therapeutic avenue for gout and hyperuricemia.
• Current evidence from human studies is limited by small sample sizes and geographical restrictions.
• Further well-controlled studies in relevant animal models are necessary before human clinical trials can be reliably conducted.