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Chenodeoxycholic acid (CDCA), also known as chenodiol, is a naturally occurring primary bile acid synthesized in the liver from cholesterol. It is primarily used for the dissolution of radiolucent cholesterol gallstones in patients with a functioning gallbladder. Beyond its role in lipid digestion, CDCA acts as a potent agonist for the farnesoid X receptor (FXR) and the G protein-coupled bile acid receptor 1 (TGR5), which are involved in regulating bile acid synthesis, glucose metabolism, and gut hormone secretion (such as GLP-1 and PYY). It is currently being investigated for the treatment of cerebrotendinous xanthomatosis (CTX), a rare metabolic disorder characterized by a deficiency in the enzyme sterol 27-hydroxylase. CDCA has also been studied for its potential to enhance gut hormone secretion in patients who have undergone Roux-en-Y gastric bypass (RYGB).
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