Gut ecosystem: a new insight on hyperuricemia mechanisms

Hyperuricemia is a metabolic disorder characterized by elevated level of uric acid (UA). Intestinal microbiota plays an important role in the regulation of UA content. About one third of UA is excreted through the intestine, where bacteria break down purines, reducing their production and increasing excretion. Dysbiosis can disrupt this process by increasing the intestinal wall permeability and promoting inflammation, which worsens the metabolism of purines. Objective. To study the impact of intestinal microbiota on uric acid exchange, identify key mechanisms of hyperuricemia and evaluate therapeutic approaches for its prevention and treatment through microbiota correction. Materials and methods. A systematic search for publications (2020—2025) in scientific databases was carried out in order to analyze the mechanisms of hyperuricemia with emphasis on the role of intestinal microbiota. The following keywords were used: hyperuricemia, uric acid, intestinal microbiota, dysbiosis, purine exchange, intestinal excretion, interstitial permeability, inflammation, probiotics, prebiotics, fecal microbiota transplantation, diet, lifestyle. Results. The studies confirm the important role of intestinal microbiota in the regulation of UA level. About a third of UA is excreted through the intestine, where certain bacteria promote degradation of purines by reducing UA production, while others may increase it. Correction of microbiota by means of probiotics, prebiotics, herbal medicinal products and fecal microbiota transplantation is a promising therapeutic approach.