Pathophysiological Mechanisms of Hyperuricemia and the Therapeutic Potential of Food and Medicine Homologous Substances

Background: In recent years, hyperuricemia (HUA) has shown an increasing prevalence and a trend toward younger onset, posing a significant burden on public health. The side effects of current therapeutic drugs limit their clinical application, while food and medicine homologous substances (substances that are both food and Chinese medicinal materials) demonstrate unique value in HUA prevention and treatment due to their multi-component, multi-target synergistic regulatory advantages, as well as excellent safety and tolerability. Methods: This article systematically summarizes the pathophysiological mechanisms of HUA, including the source of purine, the synthesis and excretion of uric acid, and the inducing factors of HUA. The interaction between HUA and various diseases such as gout, kidney disease, and cardiovascular disease was discussed. The uric acid-lowering effect and molecular mechanism of 10 typical food-medicine homologous substances were focused on, including Chicory, Gardenia, Poria, Lotus leaf, Pueraria root, Chrysanthemum, Galangal, Turmeric, Perilla, and Astragalus. Results and Conclusions: HUA is a chronic metabolic disease caused by purine metabolism dysfunction, leading to elevated serum uric acid levels. Increased uric acid production (and) or decreased excretion serve as a key biochemical basis for HUA. Prolonged HUA not only triggers gouty arthritis but also has a significant correlation with the development of type 2 diabetes, chronic kidney disease, and cardiovascular diseases. Various food-medicine homologous substances regulate serum uric acid levels through multiple pathways, including inhibiting xanthine oxidase (XOD) activity, modulating urate transporter expression, and blocking oxidative stress and inflammatory cascades. This review provides a theoretical foundation for developing novel and highly effective functional foods with uric acid-lowering properties while promoting the clinical application of food-medicine homologous substances in metabolic disease prevention and treatment.