The microbiome of people with gout resembles that of patients with autoimmune disease, with loss of butyrate-producing bacteria and higher levels of Bacteroides, Prevotella, and Fusobacterium, the gum disease and colorectal cancer-linked bacterium.
Patients with gout have a completely different microbiome to healthy individuals; it is associated with chronic inflammation and unregulated urate degradation.
Given similarities between arthritis and gout, and that arthritis has been increasingly linked with a changed microbiome, the researchers sought to discover exactly what was going on in the microbiome of patients with gout (1).
In this large metagenomic analysis, the researchers examined 307 fecal samples from 102 patients with gout, and 86 healthy individuals. The study included two cohorts – the first ‘discovery group’ and a second cohort to ‘verify the findings’.
The patients with gout had lost diversity in their microbiomes. Healthy people had higher levels of bacterium SS3/4, Enterobacteriaceae species, and several butyrate-producing species, such as Roseburia species, Coprococcus species, Eubacteriumspecies, and F prausnitzii. Butyrate is known to be highly anti-inflammatory.
However, Bacteroides, Prevotella, and Fusobacterium were enriched in patients with gout and the ratio of Bacteroidetes to Firmicutes was higher in patients with gout. 110 ‘families’ and 223 strains were significantly different in abundance between patients with gout and healthy individuals.
Patients with gout had more bacterial genes involved in mannose and fructose metabolism and lipid A synthesis, and less genes in urate degradation and short-chain fatty acid (butyrate, acetate and propionate) production. Among patients with gout, there was an association between low Enterobacteriaceae and reduced amino acid metabolism, leading to increased serum uric acid and highly inflammatory C-reactive protein levels.
Treating gout with uric-acid-lowering drugs and anti-inflammatory medications partially restored the gut microbiome after 24 weeks.
In summary, gout microbiota and their genes were typical of people with autoimmune and metabolic disorders.
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- Chu Y, Sun S, Huang Y, et al. Metagenomic analysis revealed the potential role of gut microbiome in gout. NPJ Biofilms Microbiomes. 2021;7(1):66. doi:10.1038/s41522-021-00235-2