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Additionally, metabolites derived from GM can act as damage-associated molecular patterns (DAMPs) by binding to PRRs on the surface of liver cells such as Kupffer cells (KCs), liver sinusoidal endothelial cells (LSECs), and cholangiocytes, thereby inducing hepatic immune responses and aggravating inflammatory liver injury (Wang R

Govindaraj P, Parayil Sankaran B, Nagappa M et al (2020) Child neurology: ethylmalonic encephalopathy

Among these mediators, CXCL1 plays a key role by recruiting neutrophils to the inflamed joint, where they further amplify inflammation through the release of NETs and related mechanisms, ultimately driving acute gouty arthritis (76, 77)

This medication may be a proton pump inhibitor or H2 blocker