肠道微生物与高尿酸血症的关联及创新性治疗

Association between gut microbiota and hyperuricemia: insights into innovative therapeutic strategies

摘要:

尿酸(uric acid, UA)是人体内嘌呤的最终代谢物，若人体内尿酸生成和排泄稳态失调导致血液中尿酸含量升高，将会引起高尿酸血症(hyperuricemia, HUA)。人体约有1/3的尿酸经肠道排泄，而肠道菌群作为肠道内环境的重要组成部分，在调节血液尿酸水平方面发挥重要作用，其组成的变化或失衡与高尿酸血症的发生具有显著关联性，因此肠道菌群有可能成为预防和治疗高尿酸血症的新靶标。本文综述了高尿酸血症的发生机制及危害、高尿酸血症与肠道微生物及其代谢产物的关联，探讨了以肠道微生物为靶点治疗高尿酸血症的分子机制，总结了具有降尿酸作用的益生菌、益生元和传统的单味中药与中药复方，以及粪菌移植、机器学习等前沿技术在高尿酸血症治疗的潜在应用，为高尿酸血症的防治提供了新的思路和参考。

Abstract:

Uric acid (UA) is the final metabolite of purines in the human body. An imbalance in UA production and excretion that disrupts homeostasis leads to elevated blood UA levels and the development of hyperuricemia (HUA). Approximately one-third of UA is excreted through the intestinal tract. As a crucial component of the intestinal microenvironment, the gut microbiota plays a pivotal role in regulating blood UA levels. Alterations or imbalances in gut microbiota composition are linked to the onset of HUA, which implies the potential of gut microbiota as a novel target for the prevention and treatment of HUA. This review introduces the occurrence mechanism and damage of hyperuricemia, examines the association between HUA and the gut microbiota and their metabolites, and explores the molecular mechanisms underlying gut microbiota-targeted therapies for HUA. Furthermore, it discusses the potential applications of probiotics, prebiotics, and traditional Chinese medicine (including both single herbs and compound formulas) with UA-lowering effects, along with cutting-edge technologies such as fecal microbiota transplantation and machine learning in HUA treatment. This review provides valuable perspectives and strategies for improving the prevention and treatment of HUA.