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Hepato-ocular crosstalk: Bile acids bridging pathogenesis and therapy
Peng Wang1, Jingchen Xie1, Feng Xiang1
1Key Laboratory for Quality Evaluation of Bulk Herbs of Hunan Province, School of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, China.
Iscience
|March 19, 2026
Summary
Dysregulated bile acid metabolism links liver disease to eye problems. Restoring bile acid balance offers a unified treatment approach for related liver-eye conditions.
Area of Science:
- Biochemistry
- Ophthalmology
- Hepatology
Background:
- Bile acids are cholesterol metabolites with signaling functions beyond digestion.
- Dysregulated bile acid metabolism is increasingly linked to liver and eye diseases.
- Imbalances in bile acid synthesis, transport, and signaling contribute to ocular pathology.
Purpose of the Study:
- To review the mechanisms linking bile acid imbalance to hepato-ocular comorbidities.
- To explore therapeutic strategies targeting bile acid homeostasis for treating these conditions.
Main Methods:
- Literature review focusing on bile acid metabolism, hepatic dysfunction, and ocular pathology.
- Analysis of signaling pathways (FXR, TGR5) and the gut-liver-eye axis.
- Examination of therapeutic interventions for bile acid dysregulation.
Main Results:
- Bile acid imbalance drives ocular injury via cytotoxicity, disrupted retinal/lens homeostasis, and immune activation.
- These mechanisms are relevant in both inherited metabolic and acquired cholestatic diseases.
- Targeting bile acid homeostasis shows translational potential for treating hepato-ocular conditions.
Conclusions:
- Reconstructing systemic bile acid homeostasis provides a unifying therapeutic framework.
- Interventions include bile acid-based therapies, targeted drug delivery, and microbiome modulation.
- Restoring bile acid balance is key for managing liver and eye disease comorbidities.
Keywords:
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