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World J Gastroenterol. Dec 28, 2022; 28(48): 6846-6866
Published online Dec 28, 2022. doi: 10.3748/wjg.v28.i48.6846
Bile acids and microbes in metabolic disease
Dhiraj Kumar Sah, Archana Arjunan, Sun Young Park, Young Do Jung
Dhiraj Kumar Sah, Archana Arjunan, Young Do Jung, Department of Biochemistry, Chonnam National University, Gwangju 501190, South Korea
Sun Young Park, Department of Internal Medicine, Chonnam National University, Gwangju 501190, South Korea
Author contributions: Sah DK and Jung YD contributed to the conceptualization; Sah DK, Arjunan A and Park SY contributed to the data curation; Sah DK, Arjunan A and Jung YD contributed to the investigation and software; Jung YD contributed to the project administration and supervision; Sah DK, Park SY and Jung YD contributed to the writing of the original draft; Arjunan A, Park SY and Jung YD contributed to the writing, review and editing.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Young Do Jung, MD, PhD, Professor, Department of Biochemistry, Chonnam National University, 5 Hakdong, Gwangju 501190, South Korea. ydjung@jnu.ac.kr
Received: September 20, 2022
Peer-review started: September 20, 2022
First decision: October 18, 2022
Revised: November 1, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 28, 2022
Processing time: 98 Days and 1.1 Hours
Abstract

Bile acids (BAs) serve as physiological detergents that enable the intestinal absorption and transportation of nutrients, lipids and vitamins. BAs are primarily produced by humans to catabolize cholesterol and play crucial roles in gut metabolism, microbiota habitat regulation and cell signaling. BA-activated nuclear receptors regulate the enterohepatic circulation of BAs which play a role in energy, lipid, glucose, and drug metabolism. The gut microbiota plays an essential role in the biotransformation of BAs and regulates BAs composition and metabolism. Therefore, altered gut microbial and BAs activity can affect human metabolism and thus result in the alteration of metabolic pathways and the occurrence of metabolic diseases/syndromes, such as diabetes mellitus, obesity/hypercholesterolemia, and cardiovascular diseases. BAs and their metabolites are used to treat altered gut microbiota and metabolic diseases. This review explores the increasing body of evidence that links alterations of gut microbial activity and BAs with the pathogenesis of metabolic diseases. Moreover, we summarize existing research on gut microbes and BAs in relation to intracellular pathways pertinent to metabolic disorders. Finally, we discuss how therapeutic interventions using BAs can facilitate microbiome functioning and ease metabolic diseases.

Keywords: Bile acids; Metabolic diseases; Gut microbe; Diabetic mellitus; Obesity; Hypercholesterolemia

Core Tip: Bile acids (BAs) in enterohepatic circulation regulate metabolism through interorgan communication between the gut and liver microbiota. BAs secreted from the liver contribute to glucose and lipid metabolism. Disruption of the BA-gut microbiome link contributes to the occurrence of metabolic diseases, such as obesity, type 2 diabetic mellitus, and dyslipidemia. BAs and their metabolites can be used as potential therapeutics for treating metabolic diseases.