Non-Alcoholic Fatty Liver Disease: The Effect of Bile Acids and Farnesoid X Receptor Agonists on Pathophysiology and Treatment

Abstract

Non-alcoholic fatty liver disease (NAFLD) is an emerging epidemic in light of its 
two predisposing factors, a surge in both obesity and diabetes rates with reports of between 
70-80% of obese individuals in Western countries. The disease progression of NAFLD remains 
elusive but is generally attributed to insulin resistance, lipid metabolism dysfunction, altered 
immune response to name a few. Potential therapeutic strategies should target one or some of 
these pathological events in the liver, however currently no specific therapies for NAFLD exist. 
Thus novel therapeutic approaches to manage the chronic liver disease epidemic are becoming essential. In this review we discuss the evidence supporting the role of bile acid activated 
Farnesoid X Receptor (FXR) in promoting lipid oxidation, reducing inflammation and fibrosis 
in the liver. We also examine the potential of FXR agonists, as an attractive class of drugs for 
the safe and effective treatment of NAFLD.