Bile acid pool and bile flow

The bile acid pool and bile flow represent the integrated physiological system responsible for the synthesis, secretion, and recycling of bile acids through the enterohepatic circulation (StatPearls, 2023). Bile acids are synthesized from cholesterol in the liver, stored in the gallbladder, and released into the duodenum to facilitate the digestion and absorption of lipids and fat-soluble vitamins (NIH, 2022). Beyond digestion, the bile acid pool acts as a complex signaling network, activating receptors such as the Farnesoid X Receptor (FXR) and TGR5 to regulate glucose and lipid metabolism (Nature Reviews Gastroenterology & Hepatology, 2017). Disruptions in bile flow (cholestasis) or alterations in the bile acid pool size and composition are central to the pathogenesis of various hepatobiliary and metabolic diseases, including primary biliary cholangitis and gallstone disease (PubMed, 2021). Therapeutic strategies often focus on specific molecular components of this system, such as transporters (e.g., ASBT) or nuclear receptors, to restore homeostasis or reduce toxic bile acid accumulation (Journal of Hepatology, 2020).

Other names

Enterohepatic circulationBile acid homeostasisBiliary secretionBile acid pool

Therapeutic modulation involves the sequestration of bile acids in the intestine, activation of nuclear receptors (FXR) to suppress synthesis, or inhibition of the apical sodium-dependent bile acid transporter (ASBT) to interrupt enterohepatic circulation (Liver International, 2022).