痛风与尿酸代谢相关的肠道及肠道外菌群调控机制的研究进展

doi:10.16138/j.1673-6087.2026.01.13

内科理论与实践 ›› 2026, Vol. 21 ›› Issue (01): 85-90.doi: 10.16138/j.1673-6087.2026.01.13

痛风与尿酸代谢相关的肠道及肠道外菌群调控机制的研究进展

刘志成(), 陈银子, 杨一帆, 徐健, 刘爽^*()

昆明医科大学第一附属医院风湿免疫科，云南昆明 650032

收稿日期:2025-08-04 修回日期:2025-09-23 接受日期:2025-10-15 出版日期:2026-02-25 发布日期:2026-04-08
通讯作者: 刘爽 E-mail：liushuang_pku@163.com
基金资助:
国家自然科学基金项目(32270947);云南省“万人计划”专项培养计划任务(YN-WR-MY-2018-040);云南省卫生健康委员会医学领军人才培养计划(L-2019004);云南省科技厅科技计划项目(202301AY070001-159);云南省“万人计划”青年拔尖人才(YNWR-QNBJ-2018-152);昆明医科大学第一附属医院“535”高层次人才青年学术骨干(2022535Q01);白求恩·普爱医学研究基金(PAYJ-043);云南省临床医学中心科研项目(YWLCYXZX2023300076);云南省临床医学中心科研项目(2024YNLCYXZX0019);云南省临床医学中心科研项目(2024YNLCYXZX0031);云南省临床医学中心科研项目(2024YNLCYXZX0042);昆明医科大学2025年研究生教育创新基金(2025S042)

Research progress on the regulatory mechanisms of gut and extraintestinal microbiota in gout and uric acid metabolism

LIU Zhicheng(), CHEN Yinzi, YANG Yifan, XU Jian, LIU Shuang^*()

Department of Rheumatology and Immunology, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China

Received:2025-08-04 Revised:2025-09-23 Accepted:2025-10-15 Online:2026-02-25 Published:2026-04-08

摘要/Abstract

摘要：

痛风是一种以尿酸代谢紊乱为特征的自身炎症代谢性疾病。近年来，宏基因组学的进展推动了痛风相关菌群研究的深入，尤其关注肠道、口腔、尿液菌群及其对尿酸代谢的调控作用。痛风相关肠道菌群失衡表现为益生菌减少、机会致病菌增加，可通过影响尿酸代谢酶、尿酸转运蛋白、肠道屏障功能及炎症信号通路，进而调控尿酸生成与排泄。同时，口腔和尿液菌群的初步研究提示其可能不仅作为生物标志物，还通过“口腔-肠道迁移”及尿液菌群改变等途径参与痛风的炎症反应。微生态干预，包括益生元、益生菌、菌群移植及中药活性成分，可通过改善菌群稳态、促进肾外尿酸排泄及减轻炎症，为痛风管理提供潜在的临床转化价值。未来研究应进一步阐明菌群与痛风的因果关系，开发精准的微生态干预策略，为个性化治疗和疾病管理提供理论依据与实践指导。

关键词: 痛风, 高尿酸血症, 肠道菌群, 口腔菌群, 尿液菌群, 尿酸代谢

Abstract:

Gout is an autoinflammatory metabolic disorder characterized by dysregulation of uric acid metabolism. Recent advances in metagenomics have propelled in-depth research on gout-associated microbiota, with particular attention to the gut, oral, urinary microbiota and their regulatory roles in uric acid metabolism. Dysbiosis of the gout-related gut microbiota is typified by a reduction in probiotics and an increase in opportunistic pathogens, which can regulate uric acid production and excretion by affecting urate-metabolizing enzymes, urate transporters, intestinal barrier function, and inflammatory signaling pathways. Meanwhile, preliminary studies on oral and urinary microbiota suggest that they may not only serve as biomarkers but also participate in the inflammatory response of gout through mechanisms such as “oral-gut translocation” and alterations in urinary microbiota. Microecological interventions—including prebiotics, probiotics, microbiota transplantation, and bioactive compounds derived from traditional Chinese medicine—hold potential clinical translational value in gout management by improving microbial homeostasis, promoting extra-renal urate excretion, and alleviating inflammation. Future research should further elucidate the causal relationship between microbiota and gout, and develop precise microecological intervention strategies to provide theoretical basis and practical guidance for personalized treatment and disease management.

Key words: gout, hyperuricemia, gut microbiota, oral microbiota, urinary microbiota, uric acid metabolism

中图分类号:

刘志成, 陈银子, 杨一帆, 徐健, 刘爽. 痛风与尿酸代谢相关的肠道及肠道外菌群调控机制的研究进展[J]. 内科理论与实践, 2026, 21(01): 85-90.

LIU Zhicheng, CHEN Yinzi, YANG Yifan, XU Jian, LIU Shuang. Research progress on the regulatory mechanisms of gut and extraintestinal microbiota in gout and uric acid metabolism[J]. Journal of Internal Medicine Concepts & Practice, 2026, 21(01): 85-90.

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痛风与尿酸代谢相关的肠道及肠道外菌群调控机制的研究进展

Research progress on the regulatory mechanisms of gut and extraintestinal microbiota in gout and uric acid metabolism

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