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New insights in the multiple roles of bile acids and their signaling pathways in metabolic control

de Boer, Jan, Frearka,b; Bloks, Vincent, W.a; Verkade, Esthera; Heiner-Fokkema, M., Rebeccab; Kuipers, Folkerta,b

Current Opinion in Lipidology: June 2018 - Volume 29 - Issue 3 - p 194–202
doi: 10.1097/MOL.0000000000000508
LIPID METABOLISM: Edited by Marit Westerterp and Bart van de Sluis

Purpose of review There is a growing awareness that individual bile acid species exert different physiological functions, beyond their classical roles in bile formation and fat absorption, due to differential stimulatory effects on the bile-acid-activated receptors farnesoid X receptor (FXR) and takeda G receptor 5 (TGR5). This review integrates recent findings on the role of individual bile acids and their receptors in metabolic control, with special emphasis on cholesterol homeostasis.

Recent findings The consequences of altered bile acid metabolism, for example, in type 2 diabetes and during aging, on metabolic control is increasingly recognized but full impact hereof remains to be elucidated. These effects interact with those of newly developed pharmacological FXR and TGR5 modulators that aim to improve metabolic health. Studies in genetically modified mice have provided important new insights, for example, establishment of the role of intestinal FXR in control of the transintestinal cholesterol excretion pathway. However, translation from mice to men is hampered by the presence of rodent-specific bile acid species with special features.

Summary Specific bile acids and their signaling pathways play important roles in control of (cholesterol) metabolism. Deeper insight into the interactions between endogenous (i.e., bile acids) and pharmacological modulators of FXR and TGR5 is needed to optimize therapeutic benefit of the latter. The recent identification of cytochrome P450 2C70 as key enzyme in the formation of rodent-specific hydrophilic muricholic acids allows for the development of adequate mouse models for this purpose.

aDepartment of Pediatrics

bDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

Correspondence to Folkert Kuipers, PhD, Laboratory of Pediatrics, University Medical Center Groningen, Y2.145, Hanzeplein 1, 9713GZ Groningen, The Netherlands. Tel: +00 31 50 3616620; e-mail:

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