Bile Acid Receptors FXR and TGR5 Emerge as Master Switches in Liver Disease

A major review published in Pharmacology Research & Perspectives argues that bile acids are far more than digestive detergents, positioning two receptors—FXR and TGR5—as key “master switches” in liver disease. Synthesizing hundreds of studies, the article explains how the nuclear receptor FXR and the membrane receptor TGR5 coordinate control of fat accumulation and scarring, inflammation, and even cancer risk. It details FXR’s signaling network, including suppression of bile-acid synthesis enzymes and metabolic effects on fatty acid and glucose pathways, as well as anti-inflammatory actions via inhibition of NF-κB and blocking the NLRP3 inflammasome. Despite their central role, the review notes past drug-candidate failures in late-stage trials.