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Published on: November 15, 2013
The Farnesoid X Receptor: Good for BAD
Stephen J Keely1, Julian R F Walters2
1Molecular Medicine Laboratories, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
Bile acid diarrhea affects 1% of adults, with current treatments often failing. Farnesoid X receptor (FXR) agonists show promise for treating this condition by regulating bile acid synthesis and fluid secretion.
Area of Science:
- Gastroenterology
- Endocrinology
- Pharmacology
Background:
- Diarrhea is a common symptom in chronic intestinal disorders.
- Increased bile acid delivery to the colon characterizes bile acid diarrhea.
- Current therapies for bile acid diarrhea are often ineffective, affecting ~1% of the adult population.
Purpose of the Study:
- To review the pathophysiology of bile acid diarrhea.
- To examine the therapeutic potential of farnesoid X receptor (FXR) agonists.
Main Methods:
- Literature review of bile acid diarrhea pathophysiology.
- Analysis of evidence for FXR agonists in treating bile acid diarrhea.
Main Results:
- Farnesoid X receptor (FXR) activation inhibits colonic fluid secretion.
- FXR agonists down-regulate hepatic bile acid synthesis via fibroblast growth factor 19 (FGF19).
Conclusions:
- FXR is a promising therapeutic target for bile acid diarrhea.
- FXR agonists offer a potential new treatment strategy for this condition.
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