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Ursodiol is a naturally occurring, hydrophilic bile acid that is clinically used to dissolve cholesterol gallstones and treat primary biliary cholangitis. In research sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), ursodiol is being investigated for its potential role in managing obesity and metabolic disorders. The hypothesized mechanism involves the stimulation of energy expenditure through the activation of the G protein-coupled bile acid receptor 1 (TGR5). Activation of TGR5 in metabolic tissues like brown adipose tissue and skeletal muscle triggers an intracellular signaling cascade that increases the activity of type 2 iodothyronine deiodinase (D2). This enzyme converts the inactive thyroid hormone thyroxine (T4) into its active form, triiodothyronine (T3), thereby increasing the body's metabolic rate and thermogenesis.
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