Objective Different mechanisms play role in the pathogenesis of gout and gut microbiota is believed to be one of these factors. The main goal of this systematic review is to summarize evidence regarding changes in gut microbiota composition in gout disease and uncover underlying mechanisms. Methods A comprehensive search was conducted on PubMed, Web of Science and Scopus databases up to October 2021. Animal studies and human observational studies including case-control, cross-sectional, and cohorts assessing associations between the gut microbiota composition and gout were included. The quality of the included human and animal studies has been evaluated using the Newcastle–Ottawa Quality Assessment scale (NOS) and the SYRCLE's risk of bias tool, respectively. Results 15 studies from 274 recorded studies were included in this systematic review. 10 studies on human and 5 on animals. Increase in frequency of Alistipes and decreased Enterobacteriaceae lead to changes of enzyme level in purine metabolism and aggravates gout condition. Moreover, rise of Phascolarctobacterium and Bacteroides play role in gout through enzyme modulation. Butyrate-producing bacteria such as Faecalibacterium, prausnitzii, Oscillibacter, Butyricicoccus and Bifidobacterium revealed an increase in healthy controls compared to gout patients which points to the possible underlying role of short-chain fatty acids (SCFAs) leading to both anti-inflammatory advantages and promoting intestinal barrier for host. Lipopolysaccharides (LPS)-releasing bacteria, Enterobacteriaceae, Prevotella and Bacteroides, also impact on gout disease by stimulating the innate immune system. Conclusion Exploring gut microbiota dysbiosis in gout disease and the underlying mechanisms could make a novel insight for microbiota-modulating therapies.

ObjectivesGut dysbiosis is believed to be one of the several mechanisms that are involved in the pathogenesis of gout. This systematic review aimed to summarize the role of gut dysbiosis in gout disease and uncover the underlying mechanisms.MethodsA comprehensive search was conducted on PubMed, Web of Science, and Scopus databases up to October 2021. Animal studies and human observational studies, including case-control, cross-sectional, and cohort studies assessing the association between gut microbiota composition and gout were included. The quality of included studies has been evaluated using the Newcastle–Ottawa Quality Assessment scale (NOS) and the SYRCLE's risk of bias tool.ResultsInitially, we found 274 studies among which 15 studies were included in this systematic review. Of them, 10 studies were conducted on humans and 5 studies were conducted on animals. Increased abundance of Alistipes and decreased abundance of Enterobacteriaceae alters purine metabolism, thereby aggravating gout condition. Moreover, a higher abundance of Phascolarctobacterium and Bacteroides in gout modulates enzymatic activity in purine metabolism. Butyrate-producing bacteria such as Faecalibacterium, prausnitzii, Oscillibacter, Butyricicoccus, and Bifidobacterium have higher abundance in healthy controls compared to gout patients, suggesting the anti-inflammatory and anti-microbial role of short-chain fatty acids (SCFAs). Lipopolysaccharides (LPS)-releasing bacteria, such as Enterobacteriaceae, Prevotella, and Bacteroides, are also involved in the pathogenesis of gout disease by stimulating the innate immune system.ConclusionExploring the role of gut dysbiosis in gout and the underlying mechanisms can help develop microbiota-modulating therapies for gout.