Makisterone A attenuates experimental cholestasis by activating the farnesoid X receptor

Cholestasis is the accumulation of bile acids in the liver due to impaired bile formation, secretion, and excretion caused by infections, drugs, metabolic or genetic diseases. Ursodeoxycholic acid is the only drug approved by the Food and Drug Administration for the treatment of primary biliary cholangitis, but nearly 40% of patients do not adequately respond to this drug and 5-10% show intolerance. The farnesoid X receptor (FXR) plays a key role in bile acid metabolism. Here, by using HERB, a high-throughput experimental and reference-oriented database of herbal medicines, and molecular docking, we identified makisterone A (MakA) as a compound that could target FXR. We showed that MakA enhanced FXR activity in liver cells and expression levels of FXR target genes in vitro. Importantly, MakA intervention alleviated cholestatic liver injury and dysregulation of hepatic bile acid metabolism induced by α-naphthylisothiocyanate and, 5-diethoxycarbonyl-1,4-dihydrocollidine in mice. The ability of MakA to improve liver injury in a mouse model suggests that this drug may be used for clinical treatment of cholestasis.