Bridging these gaps prioritizes engineered bio-therapeutics (recombinant uricase-expressing probiotics, nano-encapsulated metabolites targeting XO/GLUT9), diagnostic-stratified interventions (probiotic cocktails calibrated to Prevotella/SCFA profiles → synthetic consortia replacing hepatotoxic drugs), and cross-system validation (health-economic analyses against allopurinol, long-term safety monitoring via multi-omics registries)—ultimately positioning microbiota-directed strategies as first-line solutions for refractory hyperuricemia. The gene discussed is XDH; the disease is hyperuricemia.