Biagioli Michele, Fiorucci Stefano
Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Liver Res. 2021 Sep 2;5(3):119-141. doi: 10.1016/j.livres.2021.08.003. eCollection 2021 Sep.
Bile acids are a family of atypical steroids generated at the interface of liver-intestinal microbiota acting on a ubiquitously expressed family of membrane and nuclear receptors known as bile acid activated receptors. The two best characterized receptors of this family are the nuclear receptor, farnesoid X receptor (FXR) and the G protein-coupled receptor, G protein-coupled bile acid receptor 1 (GPBAR1). FXR and GPBAR1 regulate major aspects of lipid and glucose metabolism, energy balance, autophagy and immunity and have emerged as potential pharmaceutical targets for the treatment of metabolic and inflammatory disorders. Clinical trials in non-alcoholic fatty liver disease (NAFLD), however, have shown that selective FXR agonists cause side effects while their efficacy is partial. Because FXR and GPBAR1 exert additive effects, dual FXR/GPBAR1 ligands have been developed for the treatment of metabolic disorders and are currently advanced to clinical trials. Here, we will review the role of FXR and GPBAR1 agonism in NAFLD and how the two receptors could be exploited to target multiple components of the disease.
胆汁酸是一类非典型类固醇,产生于肝脏 - 肠道微生物群的界面,作用于一类广泛表达的膜受体和核受体,即胆汁酸激活受体。该家族中两个特征最明确的受体是核受体法尼醇X受体(FXR)和G蛋白偶联受体G蛋白偶联胆汁酸受体1(GPBAR1)。FXR和GPBAR1调节脂质和葡萄糖代谢、能量平衡、自噬和免疫的主要方面,并已成为治疗代谢和炎症性疾病的潜在药物靶点。然而,非酒精性脂肪性肝病(NAFLD)的临床试验表明,选择性FXR激动剂会引起副作用,且其疗效有限。由于FXR和GPBAR1具有协同作用,已开发出双FXR/GPBAR1配体用于治疗代谢紊乱,目前已进入临床试验阶段。在此,我们将综述FXR和GPBAR1激动作用在NAFLD中的作用,以及如何利用这两种受体来靶向该疾病的多个组成部分。
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