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