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**Glyco-obeticholic acid** is a glycine-conjugated, active metabolite of obeticholic acid, a semisynthetic bile acid analogue. It is formed in the liver via glycine conjugation of obeticholic acid and can be reconverted back in the gut by microorganisms[2][4]. Glyco-obeticholic acid is an agonist of the farnesoid X receptor (FXR), a nuclear receptor that regulates bile acid, lipid, and glucose metabolism[2]. FXR activation reduces hepatic bile acid synthesis and increases biliary bile acid excretion, thus decreasing hepatic cholestasis and inflammation[2]. Glyco-obeticholic acid is primarily used for laboratory research and not indicated for direct clinical use, but it is pharmacologically active and relevant as a metabolite in clinical settings where obeticholic acid is administered[2][4].
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