Bile acid metabolism and signaling, the microbiota, and metabolic disease

Pharmacol Ther. 2022 Sep:237:108238. doi: 10.1016/j.pharmthera.2022.108238. Epub 2022 Jul 2.


The diversity, composition, and function of the bacterial community inhabiting the human gastrointestinal tract contributes to host health through its role in producing energy or signaling molecules that regulate metabolic and immunologic functions. Bile acids are potent metabolic and immune signaling molecules synthesized from cholesterol in the liver and then transported to the intestine where they can undergo metabolism by gut bacteria. The combination of host- and microbiota-derived enzymatic activities contribute to the composition of the bile acid pool and thus there can be great diversity in bile acid composition that depends in part on the differences in the gut bacteria species. Bile acids can profoundly impact host metabolic and immunological functions by activating different bile acid receptors to regulate signaling pathways that control a broad range of complex symbiotic metabolic networks, including glucose, lipid, steroid and xenobiotic metabolism, and modulation of energy homeostasis. Disruption of bile acid signaling due to perturbation of the gut microbiota or dysregulation of the gut microbiota-host interaction is associated with the pathogenesis and progression of metabolic disorders. The metabolic and immunological roles of bile acids in human health have led to novel therapeutic approaches to manipulate the bile acid pool size, composition, and function by targeting one or multiple components of the microbiota-bile acid-bile acid receptor axis.

Keywords: Bile acid; Bile acid biotransformation; Bile acid-activated receptor; Gut microbiota; Metabolic disease.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Bacteria
  • Bile Acids and Salts / metabolism
  • Gastrointestinal Microbiome* / physiology
  • Humans
  • Lipid Metabolism
  • Metabolic Diseases*
  • Microbiota*


  • Bile Acids and Salts