Nuclear-receptor-mediated regulation of drug- and bile-acid-transporter proteins in gut and liver

Drug Metab Rev. 2013 Feb;45(1):48-59. doi: 10.3109/03602532.2012.748793.


Adverse drug events (ADEs) are a common cause of patient morbidity and mortality and are classically thought to result, in part, from variation in expression and activity of hepatic enzymes of drug metabolism. It is now known that alterations in the expression of genes that encode drug- and bile-acid-transporter proteins in both the gut and liver play a previously unrecognized role in determining patient drug response and eventual clinical outcome. Four nuclear receptor (NR) superfamily members, including pregnane X receptor (PXR, NR1I2), constitutive androstane receptor (NR1I3), farnesoid X receptor (NR1H4), and vitamin D receptor (NR1I1), play pivotal roles in drug- and bile-acid-activated programs of gene expression to coordinately regulate drug- and bile-acid transport activity in the intestine and liver. This review focuses on the NR-mediated gene activation of drug and bile-acid transporters in these tissues as well as the possible underlying molecular mechanisms.

Publication types

  • Review

MeSH terms

  • Animals
  • Bile Acids and Salts / metabolism*
  • Biological Transport
  • Carrier Proteins / metabolism*
  • Constitutive Androstane Receptor
  • Gastrointestinal Tract / metabolism*
  • Humans
  • Inactivation, Metabolic
  • Liver / metabolism*
  • Membrane Glycoproteins / metabolism*
  • Receptors, Cytoplasmic and Nuclear / genetics
  • Receptors, Cytoplasmic and Nuclear / metabolism*


  • Bile Acids and Salts
  • Carrier Proteins
  • Constitutive Androstane Receptor
  • Membrane Glycoproteins
  • NR1I3 protein, human
  • Receptors, Cytoplasmic and Nuclear
  • bile acid binding proteins