Potassium sodium hydrogen citrate intervention on gut microbiota and clinical features in uric acid stone patients

Abstract

The high recurrence rate of renal uric acid stone (UAS) poses a significant challenge for urologists, and potassium sodium hydrogen citrate (PSHC) has been proven to be an effective oral dissolution drug. However, no studies have investigated the impact of PSHC on gut microbiota and its metabolites during stone dissolution therapy. We prospectively recruited 37 UAS patients and 40 healthy subjects, of which 12 patients completed a 3-month pharmacological intervention. Fasting vein blood was extracted and mid-stream urine was retained for biochemical testing. Fecal samples were collected for 16S ribosomal RNA (rRNA) gene sequencing and short chain fatty acids (SCFAs) content determination. UAS patients exhibited comorbidities such as obesity, hypertension, gout, and dyslipidemia. The richness and diversity of the gut microbiota were significantly decreased in UAS patients, Bacteroides and Fusobacterium were dominant genera while Subdoligranulum and Bifidobacterium were poorly enriched. After PSHC intervention, there was a significant reduction in stone size accompanied by decreased serum uric acid and increased urinary pH levels. The abundance of pathogenic bacterium Fusobacterium was significantly downregulated following the intervention, whereas there was an upregulation observed in SCFA-producing bacteria Lachnoclostridium and Parasutterella, leading to a significant elevation in butyric acid content. Functions related to fatty acid synthesis and amino acid metabolism within the microbiota showed upregulation following PSHC intervention. The correlation analysis revealed a positive association between stone pathogenic bacteria abundance and clinical factors for stone formation, while a negative correlation with SCFAs contents. Our preliminary study revealed that alterations in gut microbiota and metabolites were the crucial physiological adaptation to PSHC intervention. Targeted regulation of microbiota and SCFA holds promise for enhancing drug therapy efficacy and preventing stone recurrence. Key points • Bacteroides and Fusobacterium were identified as dominant genera for UAS patients • After PSHC intervention, Fusobacterium decreased and butyric acid content increased • The microbiota increased capacity for fatty acid synthesis after PSHC intervention

Postbiotic of Pediococcus acidilactici GQ01, a Novel Probiotic Strain Isolated from Natural Fermented Wolfberry, Attenuates Hyperuricaemia in Mice through Modulating Uric Acid Metabolism and Gut Microbiota

“…[ 22 ]. Studies have shown that a set of conserved genes widely present in uric-acid-consuming Enterobacteriaceae encode the uric acid degradation pathway, converting uric acid to SCFAs [ 43 ]. There have also been studies that have shown that propionic acid and butyric acid [ 44 ] are among the SCFAs that provide ATP to the cells of the intestinal wall, which excretes uric acid [ 45 ].…”

Intervention with fructooligosaccharides, Saccharomyces boulardii, and their combination in a colitis mouse model

“…Ileibacterium has previously been linked to metabolic disorders and intestinal inflammation ( Gao X. et al, 2021 ; Lin et al, 2022 ). However, some studies have shown that Ileibacterium and Parasutterella are positively correlated with butyric acid production ( Huang et al, 2023 ; Cao et al, 2024 ). In the present study, the abundance of Ileibacterium and Parasutterella in the Ctrl group was significantly lower than that in the DSS group.…”