AUTHOR=Mao Qingyi , Lin Beibei , Zhang Wenluo , Zhang Yu , Zhang Yu , Cao Qian , Xu Mengque 

TITLE=Understanding the role of ursodeoxycholic acid and gut microbiome in non-alcoholic fatty liver disease: current evidence and perspectives

JOURNAL=Frontiers in Pharmacology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1371574

DOI=10.3389/fphar.2024.1371574

ISSN=1663-9812

ABSTRACT=<p>Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, resulting in a huge medical burden worldwide. Accumulating evidence suggests that the gut microbiome and bile acids play pivotal roles during the development of NAFLD. Patients with NAFLD exhibit unique signatures of the intestinal microbiome marked by the priority of Gram-negative bacteria, decreased ratio of <italic>Firmicutes/Bacteroidetes</italic> (F/B), and increased <italic>Prevotella</italic> and <italic>Lachnospiraceae</italic>. The intestinal microbiota is involved in the metabolism of bile acids. Ursodeoxycholic acid (UDCA) is a key determinant in maintaining the dynamic communication between the host and gut microbiota. It generally shows surprising therapeutic potential in NAFLD with several mechanisms, such as improving cellular autophagy, apoptosis, and mitochondrial functions. This action is based on its direct or indirect effect, targeting the farnesoid X receptor (FXR) and various other nuclear receptors. This review aims to discuss the current studies on the involvement of the microbiome–UDCA interface in NAFLD therapy and provide prospective insights into future preventative and therapeutic approaches for NAFLD.</p>