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08 Apr 2015
Sufferers will testify to the fact that gout is an extremely unpleasant and painful condition, which is unpredictable and can blight the lives of those afflicted with repeated attacks. Ouch!
So where do probiotics fit into this picture?
Well, first let’s take a look at how and why the condition develops...
Gout occurs when there are high levels of uric acid circulating in the bloodstream, a situation known as hyperuricemia. The accumulation of crystals causes acute inflammation around the afflicted joint, which can become red, swollen and incredibly sore in a very short time and remain so for between 3-10 days.
Urid acid is a by-product that is created when the body breaks down substances known as purines, a chemical compound that the body uses to form adenine and guanine, which in turn are used to form DNA and RNA. The uric acid is normally carried in the bloodstream to the kidneys where it is excreted in urine; however, some individuals have a problem breaking down excess levels of uric acid and consequently tiny crystals of sodium urate can begin to accumulate around joints in the body, usually in the extremities and in particular the big toe, which is why gouty old men from the pages of history are always depicted with a huge bandage on their foot!
In fact, gout was once known as the ‘rich man’s disease,’ as the condition can be partially caused by consumption of purine-rich foods such as meat, shellfish and offal, once foods only available in plentiful quantities to the wealthy. Nowadays these foods are more readily available, but for some, that luxury comes at a price. Those who are afflicted can therefore help to manage the condition by watching their diet, but as are purines are present in such a broad range of commonly-consumed foods, a purine-free diet can be quite restrictive.
Pain and discomfort are not the only considerations for gout-sufferers, however, as hyperuricemia has also been implicated in the development of other more serious conditions such as arteriosclerosis, cerebrovascular and cardiovascular diseases, along with nephropathy in diabetic patients. Conventional treatments for the condition include heavy duty pain relief using non-steroidal anti-inflammatory drugs (NSAIDs) and steroids, but it is well-known that these drugs can have equally unpleasant side effects.
So the options are fairly grim for gout-sufferers – a very restricted diet and a cocktail of drugs that can cause other issues that are almost as bad as the condition itself.
Well, research into this field is so far limited but promising, with one 2014 Chinese study1indicating that lactic acid bacteria may have the ability to break down the uric acid, as an excerpt from the study abstract suggests:
“Foods high in purine compounds are more potent in exacerbating hyperuricemia. Therefore, the development of probiotics that efficiently degrade purine compounds is a promising potential therapy for the prevention of hyperuricemia.”
For the purposes of the study, which was published in PLoS ONE (Impact Factor: 3.53) in September 2014, a total of fifty-five different lactic acid-producing live cultures were derived from Chinese sauerkraut, The research team then monitored the bacteria’s ability to degrade two substances that are involved in purine metabolism, inosine and guanosine. The bacteria were also tested for acid tolerance, bile tolerance, anti-pathogenic bacteria activity, cell adhesion ability, resistance to antibiotics and the ability to produce hydrogen peroxide.
Of the fifty-five candidates, three strains of bacteria were identified as being particularly effective, with one, DM9218, showing the best probiotic potential compared with the other strains despite its poor bile resistance. DM9218 was found to have a 99% similarity to Lactobacillus plantarum WCFS1, and a derivative strain, DM9218-A, was found to have better resistance to 0.3% bile salts, and was proven to survive in the gastrointestinal tract of rats. The research team therefore proposed that DM9218-A has potential to be developed as a probiotic in the prevention of hyperuricemia in the normal population.
Probiotics are already widely used to help reduce inflammation; beneficial bacteria can help to modulate immune responses.
However, until more research is done in this area, supplementing with a high-quality, broad spectrum probiotic to help facilitate digestion might, in theory, help gout sufferers to better metabolise purines and uric acid.
For further reading, you might be interested in:
Li, M., Yang, D., Mei, L., Yuan, L., Xie, A. and Yuan, J., 2014. Screening and Characterization of Purine Nucleoside Degrading Lactic Acid Bacteria Isolated from Chinese Sauerkraut and Evaluation of the Serum Uric Acid Lowering Effect in Hyperuricemic Rats. PLoS ONE, 9(9), p.e105577.
Image credit 1: Web MD http://www.webmd.com/arthritis/ss/slideshow-gout
Image credit 2: Daily Mirror: http://www.mirror.co.uk/lifestyle/health/gout-no-laughing-matter-serious-3155837