Koval S., Snigurska I., Bozhko V. , Miloslavsky D., Gridasova L.

Summary. The review provides literature data on the pathogenesis of hyperuricemia and gout. It has been shown that gout is now considered more an autoimmune pathology than just of uric acid metabolism disorder. The cited works analysis shows that at present researchers pay attention not only to the renal, but also to the extra renal (intestinal) way of urate excretion. The review provides data on the main urate transporters of the intestine. The role of gut microbiota in purine metabolism has also been noted. It was shown that patients with gout have a higher prevalence of bacteria of the families Prevotella, Fusobacterium and Bacteroides, while healthy individuals have a higher abundance of Roseburia, Butyrivibrio, Coprococcus and Faecalibacterium prausnitzii species. It is also noted that the intestinal microflora is involved in the processes of nonspecific gout polyarthritis inflammation. However, it is noted that similar changes in the qualitative and quantitative composition of the intestinal microbiota are detected not only in various disorders of purine metabolism, but also in obesity, insulin resistance, arterial hypertension, atherosclerosis. The reasons may be the links of pathogenesis common to these pathologies — the predominance of pressor factors of the renin-angiotensin system, followed by overproduction of free peroxide radicals, blockade of nitric oxide production, lipid metabolism disorders, attachment and aggravation of nonspecific inflammation processes.

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