Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2021; 9(2): 308-320
Published online Jan 16, 2021. doi: 10.12998/wjcc.v9.i2.308
Overview of bile acid signaling in the cardiovascular system
Rou Zhang, Wen-Qi Ma, Meng-Jun Fu, Juan Li, Chun-Hua Hu, Yi Chen, Mi-Mi Zhou, Zhi-Jie Gao, Ying-Li He
Rou Zhang, Wen-Qi Ma, Meng-Jun Fu, Juan Li, Chun-Hua Hu, Yi Chen, Mi-Mi Zhou, Zhi-Jie Gao, Ying-Li He, Department of Infectious Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Zhang R performed the majority of the writing; Ma WQ prepared the figures and tables; Li J, Fu MJ, Hu CH, and Chen Y acquired the data and wrote the paper; Zhou MM and Gao ZJ revised the paper; He YL designed the outline and coordinated the writing of the paper; All authors have read and approve the final manuscript.
Supported by National Natural Science Foundation of China, No. 82070641.
Conflict-of-interest statement: All authors declare that: (1) No support, financial or otherwise, has been received from any organization that may have an interest in the submitted work; and (2) There are no other relationships or activities that could appear to have influenced the submitted work.
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:
Corresponding author: Ying-Li He, MD, PhD, Associate Chief Physician, Department of Infectious Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta Road (w), Xi’an 710061, Shaanxi Province, China.
Received: July 6, 2020
Peer-review started: July 6, 2020
First decision: September 12, 2020
Revised: September 28, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: January 16, 2021

Bile acids (BAs) are classically known to play a vital role in the metabolism of lipids and in absorption. It is now well established that BAs act as signaling molecules, activating different receptors (such as farnesoid X receptor, vitamin D receptor, Takeda G-protein-coupled receptor 5, sphingosine-1-phosphate, muscarinic receptors, and big potassium channels) and participating in the regulation of energy homeostasis and lipid and glucose metabolism. In addition, increased BAs can impair cardiovascular function in liver cirrhosis. Approximately 50% of patients with cirrhosis develop cirrhotic cardiomyopathy. Exposure to high concentrations of hydrophobic BAs has been shown to be related to adverse effects with respect to vascular tension, endothelial function, arrhythmias, coronary atherosclerotic heart disease, and heart failure. The BAs in the serum BA pool have relevant through their hydrophobicity, and the lipophilic BAs are more harmful to the heart. Interestingly, ursodeoxycholic acid is a hydrophilic BA, and it is used as a therapeutic drug to reverse and protect the harmful cardiac effects caused by hydrophobic elevated BAs. In order to elucidate the mechanism of BAs and cardiovascular function, abundant experiments have been conducted in vitro and in vivo. The aim of this review was to explore the mechanism of BAs in the cardiovascular system.

Keywords: Bile acids, Cardiovascular, Arteries, Receptors, Signaling, Cirrhosis

Core Tip: In the literature, there are some reviews on the relationship between bile acids (BAs) and the cardiovascular system. However, this is the first review to use molecular and cellular mechanisms of related pathways to explore the possible mechanism of BAs in the pathogenesis of cardiovascular disease and to classify the role of BAs in heart and other organs using a tabular form. The goal was to provide readers a more comprehensive, deeper, and clearer understanding of the function of BAs.