Natural products (NPs) for gout treatment in multiple targets and pathways

Gout develops as a consequence of longstanding hyperuricaemia leading to the deposition of monosodium urate crystals that can trigger episodes of acute inflammation, and in severe cases, impairment of vital organ function. In clinical practice, the treatment of gout has long relied on Western medicines. However, they exhibit a single mechanism of action for gout treatment and may increase the burden on target organs (e.g. allopurinol-induced liver injury and benzbromarone-associated elevated risk of kidney stones), which easily leads to the formation of a vicious cycle of 'hyperuricaemia -gouty arthritis - tissue damage'. This article summarized 129 natural products (NPs) (i.e. monomers) for gout treatment published up to August 2025, focusing on their potential mechanisms underlying the regulation of uric acid metabolism and inhibition of gouty arthritis, as well as their protective effects on target organs (i.e. improving renal function and restoring the balance of gut microbiota). Besides, the potential and prospects of NPs based on nanomaterials for gout treatment have been pointed out. In conclusion, this article comprehensively reviewed the treatment of gout by NPs through the synergistic effect of 'pathogenic mechanism regulation - target organ protection'. This review will provide a reference for improving the prognosis of gout patients and breaking through the limitations of existing therapeutic approaches.