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. 2024 Aug 7;30(29):3488–3510. doi: 10.3748/wjg.v30.i29.3488

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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

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Mechanisms associated with treatment of Poecilobdella manillensis for hyperuricemia. A: decreased of uric acid generation in liver by reducing levels of xanthine oxidase; B: Reduction of uric acid excretion from kidney by regulating the expression of glucose transporter 9, urate transporter 1, and ATP-binding cassette transporter G2; C: Improvement of gut microbiota dysbiosis and regulation of sphingolipid metabolism and galactose metabolism. CON: Normal control group; HUA: Hyperuricemia model group; LTP: Leech Poecilobdella manillensis total protein extract treatment group; ZO-1: Zonula occludens-1; URAT1: Urate transporter 1; GLUT9: Glucose transporter 9; ABCG2: ATP-binding cassette transporter G2; XOD: Xanthine oxidase.