The bile acid receptor (BAR), also known as farnesoid X receptor (FXR) or NR1H4 (nuclear receptor subfamily 1, group H, member 4), is a nuclear receptor that is encoded by the NR1H4 gene in humans.[5][6]
Function
FXR is expressed at high levels in the liver and intestine. Chenodeoxycholic acid and other bile acids are natural ligands for FXR. Similar to other nuclear receptors, when activated, FXR translocates to the cell nucleus, forms a dimer (in this case a heterodimer with RXR) and binds to hormone response elements on DNA, which up- or down-regulates the expression of certain genes.[6]
One of the primary functions of FXR activation is the suppression of cholesterol 7 alpha-hydroxylase (CYP7A1), the rate-limiting enzyme in bile acid synthesis from cholesterol. FXR does not directly bind to the CYP7A1 promoter. Rather, FXR induces expression of small heterodimer partner (SHP), which then functions to inhibit transcription of the CYP7A1 gene. FXR likewise stimulates the synthesis of fibroblast growth factor 19, which also inhibits expression of CYP7A1 and sterol 12-alpha-hydroxylase (CYP8B1) via fibroblast growth factor receptor 4. In this way, a negative feedback pathway is established in which synthesis of bile acids is inhibited when cellular levels are already high.[7]
The absence of FXR in an FXR-/- mouse model led to increased bile acids in the liver, and the spontaneous development of liver tumors.[8] Reducing the pool of bile acids in the FXR-/- mice by feeding the bile acid sequestering resin cholestyramine reduced the number and size of the malignant lesions.[citation needed]
Activation of FXR in diabetic mice reduces plasma glucose and improves insulin sensitivity, whereas inactivation of FXR has the opposite effect.[9]
Gastroesophageal adenocarcinoma
FXR is an important modulator of bile acid homeostasis.[11] Loss of FXR or bile-acid dependent inhibition of FXR in progenitor cells at the gastroesophageal junction drives gastroesophageal adenocarcinomacarcinogenesis.[11]
Interactions
Farnesoid X receptor has been shown to interact with:
^Yang F, Huang X, Yi T, Yen Y, Moore DD, Huang W. Spontaneous development of liver tumors in the absence of the bile acid receptor farnesoid X receptor. Cancer Res. 2007 Feb 1;67(3):863-7. doi: 10.1158/0008-5472.CAN-06-1078. PMID 17283114
^ abBaumeister T, Proaño-Vasco A, Metwaly A, Kleigrewe K, Kuznetsov A, Schömig L, Borgmann M, Khiat M, Anand A, Strangmann J, Böttcher K, Haller D, Dunkel A, Somoza V, Reiter S, Meng C, Thimme R, Schmid RM, Patil DT, Burgermeister E, Huang Y, Sun Y, Wang HH, Wang TC, Abrams JA, Quante M. Loss of FXR or Bile Acid-dependent Inhibition accelerate carcinogenesis of Gastroesophageal Adenocarcinoma. Cell Mol Gastroenterol Hepatol. 2025 Mar 24:101505. doi: 10.1016/j.jcmgh.2025.101505. Epub ahead of print. PMID: 40139565.
^Fiorucci S, Zampella A, Distrutti E (2012). "Development of FXR, PXR and CAR agonists and antagonists for treatment of liver disorders". Current Topics in Medicinal Chemistry. 12 (6): 605–624. doi:10.2174/156802612799436678. PMID22242859.
^Fiorucci S, Mencarelli A, Distrutti E, Zampella A (May 2012). "Farnesoid X receptor: from medicinal chemistry to clinical applications". Future Medicinal Chemistry. 4 (7): 877–891. doi:10.4155/fmc.12.41. PMID22571613.
Bramlett KS, Yao S, Burris TP (December 2000). "Correlation of farnesoid X receptor coactivator recruitment and cholesterol 7alpha-hydroxylase gene repression by bile acids". Molecular Genetics and Metabolism. 71 (4): 609–615. doi:10.1006/mgme.2000.3106. PMID11136553.
Huber RM, Murphy K, Miao B, Link JR, Cunningham MR, Rupar MJ, et al. (May 2002). "Generation of multiple farnesoid-X-receptor isoforms through the use of alternative promoters". Gene. 290 (1–2): 35–43. doi:10.1016/S0378-1119(02)00557-7. PMID12062799.
Barbier O, Torra IP, Sirvent A, Claudel T, Blanquart C, Duran-Sandoval D, et al. (June 2003). "FXR induces the UGT2B4 enzyme in hepatocytes: a potential mechanism of negative feedback control of FXR activity". Gastroenterology. 124 (7): 1926–1940. doi:10.1016/S0016-5085(03)00388-3. PMID12806625.