Pathogenesis, animal models and pharmacological treatments of hyperuricemia: A systematic review

Hyperuricemia, a common metabolic disorder, arises primarily from excessive uric acid production or impaired excretion, resulting in abnormal elevation of uric acid in extracellular fluids and tissues. Sustained hyperuricemia is closely linked to the development of gout, kidney diseases, and cardiovascular disorders. To date, hyperuricemia pathogenesis remains incompletely elucidated, with key challenges in animal model selection, therapeutic drug characterization, and the development of emerging treatments. Notably, increasing research attention has focused on traditional Chinese medicine (TCM) has gained growing research interest due to its unique advantages in treating hyperuricemia via holistic regulation and multi-targeted mechanisms. This review synthesizes these key topics, aiming to inform in-depth investigations into hyperuricemia pathogenesis, animal model optimization, and the development of TCM-centered emerging treatment strategies. The overall image depicts the transition from pathological disorder to homeostatic recovery, echoing the review’s overview of hyperuricemia’s pathogenesis, the limitations of animal models, and integrated TCM-Western medicine treatment strategies. It also specifically highlights TCM’s potential in improving pathological conditions and reestablishing bodily balance. On the left side, elements such as dark clouds, lightning, monosodium urate (MSU) crystals, inflammatory factors, and pathological cells visually embody the pathological process of hyperuricemia. This process specifically includes the inflammatory cascade triggered by MSU crystal deposition and the subsequent damage to the body. On the right side, the Taiji symbol (representing traditional Chinese medicine, TCM), sunny surroundings, and healthy cells correspond to the multi-target regulatory effects of TCM (monomers, single herbs, and formulas) as outlined in the review. • Immune homeostasis imbalance is a key pathogenic mechanism of hyperuricemia. • Standardized non-rodent animal models can enhance non-clinical research value. • Traditional Chinese medicine possesses unique advantages in treating hyperuricemia.