Microbiota from young mice counteracts susceptibility to age-related gout through modulating butyric acid levels in aged mice

Reviewer #1 (Public Review):

Gout, a prevalent form of arthritis among the elderly, exhibits an intricate relationship with age and gut microbiota. The authors found that gut microbiota plays a crucial role in determining susceptibility to age-related gout. They observed that age-related gut microbiota regulated the activation of the NLRP3 inflammasome pathway and modulated uric acid metabolism. "Younger" microbiota has a positive impact on the gut microbiota structure of old or aged mice, enhancing butanoate metabolism and butyric acid content. Finally, they found butyric acid exerts a dual effect, inhibiting inflammation in acute gout and reducing serum uric acid levels. This work's insight emphasizes the potential of a "young" gut microbiome in mitigating senile gout. The whole study was interesting, but there were some minor errors in the overall writing of the paper. The author should carefully check the spelling of the words in the text and the case consistency of the group names.

Reviewer #2 (Public Review):

Summary:

In their manuscript titled "Microbiota from Young Mice Counteracts Susceptibility to Age-Related Gout through Modulating Butyric Acid Levels in Aged Mice," the authors report that fecal transplantation from young mice into old mice alleviates susceptibility to gout. The gut microbiota in young mice is found to inhibit activation of the NLRP3 inflammasome pathway and reduce uric acid levels in the blood in the gout model.

Strengths:

They focused on the butanoate metabolism pathway based on the results of metabolomics analysis after fecal transplantation and identified butyrate as the key factor in mitigating gout susceptibility. In general, this is a well-performed study.

Weaknesses:

The discussion on the current results and previous studies regarding the effect of butyrate on gout symptoms is insufficient. The authors need to provide a more thorough discussion of other possible mechanisms and relevant literature.

Reviewer #3 (Public Review):

Summary:

This manuscript addresses an important and emerging area of research-the relationship between gut microbiota and age-related gout. The innovative aspect of this research is the demonstration that transplanting gut microbiota from young to aged mice can alleviate gout symptoms and modulate uric acid levels by increasing butyric acid levels. However, significant problems remain in the overall experimental design and manuscript writing.

Some critical comments are provided below:

(1) The data quality still needs to be improved. There are many outliers in the experimental data shown in some figures, e.g. Figure 2D-G. The presence of these outliers makes the results unreliable. The author should thoroughly review the data analysis in the manuscript. In addition, a couple of western blot bands, such as IL-1β in Figure 3C, are not clear enough, please provide clearer western blot results again to support the conclusion.

(2) As shown in Figure 1G-I, foot thickness and IL-1β content in foot tissues of the Aged+Abx group were significantly reduced, but there was no difference in serum uric acid level. In addition, the Abx-untreated group should be included at all ages.

(3) Since FMT (Figure 4) and butyrate supplementation (Figure 8) have different effects on uric acid synthesis enzyme and excretion, different mechanisms may lie behind these two interventions. Transplantation with significantly enriched single strains from young mice, such as Bifidobacterium and Akkermansia, is the more reliable approach to reveal the underlying mechanism between gut microbiota and gout.

(4) In Figure 2F, the results showed the IL-1β, IL-6, and TNF-α content in serum, which was inconsistent with the authors' manuscript description (Line 171).

(5) Figures 2F-H duplicate Supplementary Figures S1B-D. The authors should prepare the article more carefully to avoid such mistakes.

(6) In lines 202-206, the authors stated that the elevated serum uric acid levels in the Young+Old or Young+Aged groups, but there is no difference in the results shown in Figure 4A.

(7) Please visualize the results in Table 2 in a more intuitive manner.

(8) The heatmap in Figure 7A cannot strongly support the conclusion "the butyric acid content in the faeces of Young+PBS group was significantly higher than that in the Aged+PBS group". The author should re-represent the visual results and provide a reasonable explanation. In addition, please provide the ordinate unit of Supplementary Figure 7A-H.

(9) Uncropped original full-length western blot should be provided.