How painful is an acute gout attack? You go to bed feeling fine, but then you’re woken up in the middle of the night by excruciating pain that just keeps getting worse... The redness, swelling, heat, and pain in the joints are almost unbearable.(╯﹏╰)
Epidemiological studies show that the overall prevalence of gout in China has been increasing year by year, and it has become the second most common metabolic disease following diabetes. During an acute gout attack, the joint pain is severe and unbearable. Moreover, long-term high uric acid levels will damage important organs such as the heart, brain, and kidneys.
In recent years, research has found that the intestinal flora is closely related to gout attack. Two-thirds of the uric acid in the human body is excreted by the kidneys, and the rest is mainly excreted by the intestines. Bacteria in the intestine play an important role in this metabolic process.
Intestinal Flora: The Secret “Manipulator” of Gout
Gout is an inflammatory disease caused by disorders of purine metabolism, reduced uric acid excretion, or excessive uric acid production, leading to an elevated blood uric acid level. Uric acid crystals will deposit in joints and other connective tissues.
An intestinal flora expert from Hainan Chengmei Hospital introduced that gout can not only cause joint deformities but also affect the kidneys and trigger cardiovascular and cerebrovascular diseases, seriously affecting the life quality of patients.
The development of gout is the result of multiple factors. Although genes and diet are the dominant factors, more and more evidence shows that environmental factors such as the intestinal flora and its metabolites also play an important role in the development of gout.
The expert explained the role of the intestinal flora in uric acid production, transport, and the release of inflammatory factors as follows:
Regulating Uric Acid Production: Uric acid oxidase plays a key role in the decomposition of uric acid. The expert said that studies have found that the intestinal flora can secrete uric acid oxidase, Allantoic acid enzyme, and allantoicase, which degrade uric acid in the intestine into small-molecule substances and excrete them from the body.
Regulating Uric Acid Transport: Uric acid transporters are carriers of uric acid. Dysfunction of these transporters leads to reduced uric acid excretion. Current research suggests that the intestinal flora can regulate the expression of uric acid transporters, affecting uric acid transport and excretion.
Regulating Inflammatory Factors: The intestinal flora is involved in the release of inflammatory factors induced by uric acid, including active oxygen free radicals, intracellular toxins (such as lipopolysaccharide LPS), and anti-inflammatory factors (such as SCFAs). Chronic inflammation caused by an imbalance in the structure of the intestinal flora may be related to the pathogenesis of hyperuricemia.
Leverage Intestinal Flora to Bust Gout’s “Grip”
“Diet is one of the important factors affecting the intestinal flora,” the expert reminded. Unhealthy diets with high fat, protein, sugar, and salt may reduce the diversity of the intestinal flora and increase the abundance of beneficial bacteria, leading to increased uric acid production and reduced excretion.
Conversely, a healthy diet with rich dietary fiber, prebiotics, and probiotics can promote the growth and reproduction of beneficial bacteria in the intestine, improve the structure of the intestinal flora, reduce uric acid production, and promote uric acid excretion.
Expert Introduction
FMT (Fecal Microbiota Transplantation) precise flora transplantation is a new type of health intervention. Changes in the body’s blood uric acid level can cause changes in the intestinal environment, which in turn affect the structure of the intestinal flora. The intestinal flora, through its metabolites, participates in the catabolism of purine and uric acid. The two affect each other. If uric acid cannot be excreted normally, it will cause an increase in uric acid, ultimately disrupting the intestinal micro-ecosystem and forming a vicious cycle of “intestinal flora disorder↔ hyperuricemia and gout”.
FMT precise flora transplantation involves transplanting the intestinal flora of healthy people into the patient’s body to restore the balance of the intestinal micro-ecosystem. Through the colonization of beneficial bacteria in the intestine, this technology can intervene in abnormal purine and uric acid metabolism in the body, break the above-mentioned vicious cycle, achieve the effect of reducing uric acid and treating gout, and help patients get rid of the troubles of hyperuricemia and gout.
It can be seen that although the intestinal flora may act as a “troublemaker” during the metabolic process, as long as it is used reasonably, it can provide new strategies for the treatment of gout and related metabolic diseases.
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Editor | Huang Fei