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      Bile acid nuclear receptor FXR and digestive system diseases

      review-article
      a , b , a , a , b , *
      Acta Pharmaceutica Sinica. B
      Elsevier
      Bile acids, Farnesoid X receptor, Gastrointestinal tract, Inflammatory bowel disease, Colorectal cancer, Type 2 diabetes, 6-ECDCA, 6α-ethyl-chenodeoxycholic acid, AF2, activation domain, ANGTPL3, angiopoietin-like protein 3, AOM, azoxymethane, AP-1, activator protein-1, Apo, apolipoprotein, ASBT, apical sodium-dependent bile salt transporter, BAAT, bile acid-CoA amino acid N-acetyltransferase, BACS, bile acid-CoA synthetase, BAs, bile acids, BMI, body mass index, BSEP, bile salt export pump, CA, cholic acid, CD, Crohn׳s disease, CDCA, chenodeoxycholic acid, CREB, cAMP regulatory element-binding protein, CYP7A1, cholesterol 7α-hydroxylase, db/db, diabetic mice, DBD, DNA binding domain, DCA, deoxycholic acid, DSS, dextrane sodium sulfate, ERK, extracellular signal-regulated kinase, FABP6, fatty acid-binding protein subclass 6, FFAs, free fatty acids, FGF19, fibroblast growth factor 19, FGFR4, fibroblast growth factor receptor 4, FXR, farnesoid X receptor, FXRE, farnesoid X receptor response element, G6Pase, glucose-6-phosphatase, GLP-1, glucagon-like peptide 1, GLUT2, glucose transporter type 2, GPBAR, G protein-coupled BA receptor, GPCRs, G protein-coupled receptors, GSK3, glycogen synthase kinase 3, HDL-C, high density lipoprotein cholesterol, HNF4α, hepatic nuclear factor 4α, I-BABP, intestinal bile acid-binding protein, IBD, inflammatory bowel disease, IL-1, interleukin 1, KLF11, Krüppel-like factor 11, KRAS, Kirsten rat sarcoma viral oncogene homolog, LBD, ligand binding domain, LCA, lithocholic acid, LRH-1, liver receptor homolog-1, LPL, lipoprotein lipase, MCA, muricholicacid, MRP2, multidrug resistance-associated protein 2, NF-κB, nuclear factor-kappa B, NOD, non-obese diabetic, NRs, nuclear receptors, OSTα, organic solute transporter alpha, OSTβ, organic solute transporter beta, PEPCK, phosphoenol pyruvate carboxykinase, PGC-1α, peroxisome proliferators-activated receptor γ coactivator protein-1α, SHP, small heterodimer partner, SREBP-1c, sterol regulatory element-binding protein 1c, STAT3, signal transducers and activators of transcription 3, T2D, type 2 diabetes, TLCA, taurolithocholic acid, TNBS, trinitrobenzensulfonic acid, TNFα, tumor necrosis factors α, UC, ulcerative colitis, UDCA, ursodeoxycholic acid, VSG, vertical sleeve gastrectomy

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          Abstract

          Bile acids (BAs) are not only digestive surfactants but also important cell signaling molecules, which stimulate several signaling pathways to regulate some important biological processes. The bile-acid-activated nuclear receptor, farnesoid X receptor (FXR), plays a pivotal role in regulating bile acid, lipid and glucose homeostasis as well as in regulating the inflammatory responses, barrier function and prevention of bacterial translocation in the intestinal tract. As expected, FXR is involved in the pathophysiology of a wide range of diseases of gastrointestinal tract, including inflammatory bowel disease, colorectal cancer and type 2 diabetes. In this review, we discuss current knowledge of the roles of FXR in physiology of the digestive system and the related diseases. Better understanding of the roles of FXR in digestive system will accelerate the development of FXR ligands/modulators for the treatment of digestive system diseases.

          Graphical abstract

          The bile-acid-activated nuclear receptor, farnesoid X receptor (FXR), is involved in the pathophysiology of a wide range of diseases of gastrointestinal tract, including inflammatory bowel disease, colorectal cancer and type 2 diabetes. In this review, authors discuss current knowledge of the roles of FXR in physiology of the digestive system and the related diseases.

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          Most cited references106

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          Identification of a nuclear receptor for bile acids.

          Bile acids are essential for the solubilization and transport of dietary lipids and are the major products of cholesterol catabolism. Results presented here show that bile acids are physiological ligands for the farnesoid X receptor (FXR), an orphan nuclear receptor. When bound to bile acids, FXR repressed transcription of the gene encoding cholesterol 7alpha-hydroxylase, which is the rate-limiting enzyme in bile acid synthesis, and activated the gene encoding intestinal bile acid-binding protein, which is a candidate bile acid transporter. These results demonstrate a mechanism by which bile acids transcriptionally regulate their biosynthesis and enterohepatic transport.
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            Bile acids: regulation of synthesis.

            Bile acids are physiological detergents that generate bile flow and facilitate intestinal absorption and transport of lipids, nutrients, and vitamins. Bile acids also are signaling molecules and inflammatory agents that rapidly activate nuclear receptors and cell signaling pathways that regulate lipid, glucose, and energy metabolism. The enterohepatic circulation of bile acids exerts important physiological functions not only in feedback inhibition of bile acid synthesis but also in control of whole-body lipid homeostasis. In the liver, bile acids activate a nuclear receptor, farnesoid X receptor (FXR), that induces an atypical nuclear receptor small heterodimer partner, which subsequently inhibits nuclear receptors, liver-related homolog-1, and hepatocyte nuclear factor 4alpha and results in inhibiting transcription of the critical regulatory gene in bile acid synthesis, cholesterol 7alpha-hydroxylase (CYP7A1). In the intestine, FXR induces an intestinal hormone, fibroblast growth factor 15 (FGF15; or FGF19 in human), which activates hepatic FGF receptor 4 (FGFR4) signaling to inhibit bile acid synthesis. However, the mechanism by which FXR/FGF19/FGFR4 signaling inhibits CYP7A1 remains unknown. Bile acids are able to induce FGF19 in human hepatocytes, and the FGF19 autocrine pathway may exist in the human livers. Bile acids and bile acid receptors are therapeutic targets for development of drugs for treatment of cholestatic liver diseases, fatty liver diseases, diabetes, obesity, and metabolic syndrome.
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              Targeted disruption of the nuclear receptor FXR/BAR impairs bile acid and lipid homeostasis.

              Mice lacking the nuclear bile acid receptor FXR/BAR developed normally and were outwardly identical to wild-type littermates. FXR/BAR null mice were distinguished from wild-type mice by elevated serum bile acid, cholesterol, and triglycerides, increased hepatic cholesterol and triglycerides, and a proatherogenic serum lipoprotein profile. FXR/BAR null mice also had reduced bile acid pools and reduced fecal bile acid excretion due to decreased expression of the major hepatic canalicular bile acid transport protein. Bile acid repression and induction of cholesterol 7alpha-hydroxylase and the ileal bile acid binding protein, respectively, did not occur in FXR/BAR null mice, establishing the regulatory role of FXR/BAR for the expression of these genes in vivo. These data demonstrate that FXR/BAR is critical for bile acid and lipid homeostasis by virtue of its role as an intracellular bile acid sensor.
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                Author and article information

                Contributors
                Journal
                Acta Pharm Sin B
                Acta Pharm Sin B
                Acta Pharmaceutica Sinica. B
                Elsevier
                2211-3835
                2211-3843
                25 February 2015
                March 2015
                25 February 2015
                : 5
                : 2
                : 135-144
                Affiliations
                [a ]Shanghai Key Laboratory of Complex Prescriptions and MOE Key Laboratory for Standardization of Chinese Medicines, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
                [b ]Department of Diabetes and Metabolic Diseases Research, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA
                Author notes
                [* ]Corresponding author. Tel.: +1 626 256 4673x65203; fax: +1 626 256 8704. whuang@ 123456coh.org
                Article
                S2211-3835(15)00006-4
                10.1016/j.apsb.2015.01.004
                4629217
                26579439
                2eb11314-caf9-4dab-bc81-5e4d2f268235
                © 2015 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences. Production and hosting by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 1 December 2014
                : 31 December 2014
                : 5 January 2015
                Categories
                Review

                bile acids,farnesoid x receptor,gastrointestinal tract,inflammatory bowel disease,colorectal cancer,type 2 diabetes,6-ecdca, 6α-ethyl-chenodeoxycholic acid,af2, activation domain,angtpl3, angiopoietin-like protein 3,aom, azoxymethane,ap-1, activator protein-1,apo, apolipoprotein,asbt, apical sodium-dependent bile salt transporter,baat, bile acid-coa amino acid n-acetyltransferase,bacs, bile acid-coa synthetase,bas, bile acids,bmi, body mass index,bsep, bile salt export pump,ca, cholic acid,cd, crohn׳s disease,cdca, chenodeoxycholic acid,creb, camp regulatory element-binding protein,cyp7a1, cholesterol 7α-hydroxylase,db/db, diabetic mice,dbd, dna binding domain,dca, deoxycholic acid,dss, dextrane sodium sulfate,erk, extracellular signal-regulated kinase,fabp6, fatty acid-binding protein subclass 6,ffas, free fatty acids,fgf19, fibroblast growth factor 19,fgfr4, fibroblast growth factor receptor 4,fxr, farnesoid x receptor,fxre, farnesoid x receptor response element,g6pase, glucose-6-phosphatase,glp-1, glucagon-like peptide 1,glut2, glucose transporter type 2,gpbar, g protein-coupled ba receptor,gpcrs, g protein-coupled receptors,gsk3, glycogen synthase kinase 3,hdl-c, high density lipoprotein cholesterol,hnf4α, hepatic nuclear factor 4α,i-babp, intestinal bile acid-binding protein,ibd, inflammatory bowel disease,il-1, interleukin 1,klf11, krüppel-like factor 11,kras, kirsten rat sarcoma viral oncogene homolog,lbd, ligand binding domain,lca, lithocholic acid,lrh-1, liver receptor homolog-1,lpl, lipoprotein lipase,mca, muricholicacid,mrp2, multidrug resistance-associated protein 2,nf-κb, nuclear factor-kappa b,nod, non-obese diabetic,nrs, nuclear receptors,ostα, organic solute transporter alpha,ostβ, organic solute transporter beta,pepck, phosphoenol pyruvate carboxykinase,pgc-1α, peroxisome proliferators-activated receptor γ coactivator protein-1α,shp, small heterodimer partner,srebp-1c, sterol regulatory element-binding protein 1c,stat3, signal transducers and activators of transcription 3,t2d, type 2 diabetes,tlca, taurolithocholic acid,tnbs, trinitrobenzensulfonic acid,tnfα, tumor necrosis factors α,uc, ulcerative colitis,udca, ursodeoxycholic acid,vsg, vertical sleeve gastrectomy
                bile acids, farnesoid x receptor, gastrointestinal tract, inflammatory bowel disease, colorectal cancer, type 2 diabetes, 6-ecdca, 6α-ethyl-chenodeoxycholic acid, af2, activation domain, angtpl3, angiopoietin-like protein 3, aom, azoxymethane, ap-1, activator protein-1, apo, apolipoprotein, asbt, apical sodium-dependent bile salt transporter, baat, bile acid-coa amino acid n-acetyltransferase, bacs, bile acid-coa synthetase, bas, bile acids, bmi, body mass index, bsep, bile salt export pump, ca, cholic acid, cd, crohn׳s disease, cdca, chenodeoxycholic acid, creb, camp regulatory element-binding protein, cyp7a1, cholesterol 7α-hydroxylase, db/db, diabetic mice, dbd, dna binding domain, dca, deoxycholic acid, dss, dextrane sodium sulfate, erk, extracellular signal-regulated kinase, fabp6, fatty acid-binding protein subclass 6, ffas, free fatty acids, fgf19, fibroblast growth factor 19, fgfr4, fibroblast growth factor receptor 4, fxr, farnesoid x receptor, fxre, farnesoid x receptor response element, g6pase, glucose-6-phosphatase, glp-1, glucagon-like peptide 1, glut2, glucose transporter type 2, gpbar, g protein-coupled ba receptor, gpcrs, g protein-coupled receptors, gsk3, glycogen synthase kinase 3, hdl-c, high density lipoprotein cholesterol, hnf4α, hepatic nuclear factor 4α, i-babp, intestinal bile acid-binding protein, ibd, inflammatory bowel disease, il-1, interleukin 1, klf11, krüppel-like factor 11, kras, kirsten rat sarcoma viral oncogene homolog, lbd, ligand binding domain, lca, lithocholic acid, lrh-1, liver receptor homolog-1, lpl, lipoprotein lipase, mca, muricholicacid, mrp2, multidrug resistance-associated protein 2, nf-κb, nuclear factor-kappa b, nod, non-obese diabetic, nrs, nuclear receptors, ostα, organic solute transporter alpha, ostβ, organic solute transporter beta, pepck, phosphoenol pyruvate carboxykinase, pgc-1α, peroxisome proliferators-activated receptor γ coactivator protein-1α, shp, small heterodimer partner, srebp-1c, sterol regulatory element-binding protein 1c, stat3, signal transducers and activators of transcription 3, t2d, type 2 diabetes, tlca, taurolithocholic acid, tnbs, trinitrobenzensulfonic acid, tnfα, tumor necrosis factors α, uc, ulcerative colitis, udca, ursodeoxycholic acid, vsg, vertical sleeve gastrectomy

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