Review article: therapeutic aspects of bile acid signalling in the gut-liver axis.
Level 5 - mechanism / opinion, no new human data
Narrative literature review synthesizing mechanistic, preclinical, and clinical data without systematic methodology.
PubMed 34555862 · doi:10.1111/apt.16602
What was done
The authors conducted a narrative literature review summarizing experimental and clinical evidence on bile acid signaling across the gut-liver axis and evaluating therapeutic applications of nuclear bile acid receptor ligands (such as FXR agonists) and bile acid analogues in chronic liver disease.
What was found
The abstract reports no numerical values or statistical effect sizes. Qualitatively, the review notes that bile acid signaling regulates inflammation, fibrosis, endothelial function, gut barrier integrity, and antibacterial defense. It highlights that FXR agonists have demonstrated efficacy in randomized controlled trials for cholestatic and metabolic liver disease, but evidence of efficacy is lacking in decompensated cirrhosis.
Why it matters
It provides a consolidated mechanistic and translational overview of how gut-liver bile acid pathways can be targeted therapeutically, highlighting current progress and key translational gaps.
Limits
As a narrative review, it lacks systematic search methodology, risk-of-bias evaluation, and pooled quantitative analyses. The abstract contains no quantitative metrics, and clinical benefits remain unproven in advanced, decompensated liver disease.
Cited by
- supports Circulating bile activates the nuclear farnesoid X receptor (FXR) in the distal small intestine, prompting intestinal cells to secrete antimicrobial peptides that inhibit bacterial overgrowth.