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Farnesoid X receptor activation inhibits inflammation and preserves the intestinal barrier in inflammatory bowel disease
Abstract
BACKGROUND & AIMS: Inflammatory bowel disease (IBD) is characterised by chronic intestinal inflammation, resulting from dysregulation of the mucosal immune system and compromised intestinal epithelial barrier function. The bile salt, nuclear farnesoid X receptor (FXR), was recently implicated in intestinal antibacterial defence and barrier function. The aim of this study was to investigate the therapeutic potential of FXR agonists in the treatment of intestinal inflammation in complementary in vivo and in vitro models. METHODS: Colitis was induced in wild-type (WT) and Fxr-null mice using dextran sodium sulfate, and in WT mice using trinitrobenzenesulfonic acid. Mice were treated with vehicle or the FXR agonist INT-747, and colitis symptoms were assessed daily. Epithelial permeability assays and cytokine expression analysis were conducted in mouse colon and enterocyte-like cells (Caco-2/HT29) treated with medium or INT-747. Inflammatory cytokine secretion was determined by ELISA in various human immune cell types. RESULTS: INT-747-treated WT mice are protected from DSS- and TNBS-induced colitis, as shown by significant reduction of body weight loss, epithelial permeability, rectal bleeding, colonic shortening, ulceration, inflammatory cell infiltration and goblet cell loss. Furthermore, Fxr activation in intestines of WT mice and differentiated enterocyte-like cells downregulates expression of key proinflammatory cytokines and preserves epithelial barrier function. INT-747 significantly decreases tumour necrosis factor α secretion in activated human peripheral blood mononuclear cells, purified CD14 monocytes and dendritic cells, as well as in lamina propria mononuclear cells from patients with IBD. CONCLUSIONS: FXR activation prevents chemically induced intestinal inflammation, with improvement of colitis symptoms, inhibition of epithelial permeability, and reduced goblet cell loss. Furthermore, FXR activation inhibits proinflammatory cytokine production in vivo in the mouse colonic mucosa, and ex vivo in different immune cell populations. The findings provide a rationale to explore FXR agonists as a novel therapeutic strategy for IBD.
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“FXR agonists are known to alleviate endoplasmic reticulum stress and suppress oxidative damage by upregulating antioxidant and anti-apoptotic pathways [42, 43].”
From High-throughput human microfluidic organoid-on-a-chip platform for modeling liver diseases and screening nanotherapeutics. (2026) · cites this paper as [42]
In the citing paper
“Multiple reports regarding TGR5 function (Gadaleta et al., 2011;Hartmann et al., 2018;Inagaki et al., 2006;Vavassori et al., 2009) have indicated that a very fine balance between host-and microbiota-produced bile acids is required to support epithelial barrier function and control the inflammatory response in the intestine.”
From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Gadaleta et al., 2011
In the citing paper
“Activation of FXR inhibits intestinal inflammation and protects the intestinal barrier in IBD (Gadaleta et al., 2011).”
From Bacteroides dorei BDX-01 alleviates DSS-induced experimental colitis in mice by regulating intestinal bile salt hydrolase activity and the FXR-NLRP3 signaling pathway (2023) · cites this paper as Gadaleta et al., 2011
In the citing paper
“Accordingly, FXR activation by agonists GW4064 or obeticholic acid (OCA) attenuates mucosal injury, ileal barrier permeability, bacterial overgrowth and bacterial translocation in mice and rats 20,21,141,142.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [21]
In the citing paper
“treatment with a synthetic agonist of BAR has protective effects in mouse models of colitis, whereas BAR-deficient (Nr1h4−/−) mice exhibit exacerbated pathology (Gadaleta et al., 2011; Vavassori et al., 2009).”
From Understanding the Holobiont: How Microbial Metabolites Affect Human Health and Shape the Immune System (2017) · cites this paper as Gadaleta et al., 2011
In the citing paper
“In the small intestine, they are also very important for the maintenance of epithelial barrier function (Gadaleta et al., 2011; Inagaki et al., 2006).”
From Microbiota-related Changes in Bile Acid & Tryptophan Metabolism are Associated with Gastrointestinal Dysfunction in a Mouse Model of Autism (2017) · cites this paper as Gadaleta et al., 2011
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“They have a direct antimicrobial influence and an indirect action via farnesoid X receptor (FXR)-induced antimicrobial peptides that regulate the proliferation and attachment of gut microbes [68].”
BackgroundDeciphering the role of gut metabolites in non-alcoholic fatty liver disease
Ralli, T., Saifi, Z., Tyagi, N., Vidyadhari, A., Aeri, V., & Kohli, K. (2022) · Critical Reviews in Microbiology · doi:10.1080/1040841x.2022.2142091 · Cited by 22
“Additionally, they also cause release of antimicrobial peptides like angio-genin 1 (Vavassori et al. 2009; Gadaleta et al. 2011; Schwenger et al. 2019).”
BackgroundEmerging roles of host and microbial bioactive lipids in inflammatory bowel diseases
Kayama, H., & Takeda, K. (2023) · European Journal of Immunology · doi:10.1002/eji.202249866 · Cited by 21
Wang, B., Han, D. W., Hu, X., Chen, J., Liu, Y., & Wu, J. (2024) · Microbiological Research · doi:10.1016/j.micres.2024.127865 · Cited by 24
Ni, Q., Cai, C., Ren, S., Zhang, J., Zhao, Y., Wei, X., Ge, Y., Wang, C., Li, W., Wu, P., et al. (2021) · Aquaculture Research · doi:10.1111/are.15140 · Cited by 21
Kumar, A., Al-Hassi, H. O., Steed, H., Phipps, O., & Brookes, M. (2022) · Canadian Journal of Gastroenterology and Hepatology · doi:10.1155/2022/8416578 · Cited by 21
“FXR also controls several genes that protect against intestinal inflammation, intestinal permeability, and bacterial overgrowth [1, 24].”
BackgroundAn update on the effects of food-derived active peptides on the intestinal microecology
Mu, J., Lin, Q., & Liang, Y. (2022) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2022.2094889 · Cited by 21
“Helicobacter pylori inhibits tryptophan metabolism and affects immune regulation, as tryptophan concentration is negatively correlated with the occurrence and development of diseases (Fu, Guan, and Wang 2018; Gadaleta et al. 2011; Hisamatsu et al. 2012; Romani et al. 2008).”
BackgroundYang, J.-Y., Liu, M., Lv, L. L., Guo, J.-R., He, K.-Y., Zhang, H., Wang, K., Cui, C.-Y., Yan, B., Du, D., et al. (2022) · Frontiers in Microbiology · doi:10.3389/fmicb.2022.932294 · Cited by 21
“The expression and function of FXR in the intestine (especially the ileum), immune cells, and endothelial tissues have recently been characterized (Gadaleta et al., 2011; Verbeke et al., 2014).”
BackgroundHill, D. R., & Buck, R. H. (2023) · Nutrients · doi:10.3390/nu15102339 · Cited by 23
Li, S., Xu, K., Cheng, Y., Chen, L., Yi, A., Xiao, Z., Zhao, X., Chen, M., Tian, Y., Wei, M., et al. (2023) · Frontiers in Microbiology · doi:10.3389/fmicb.2023.1188455 · Cited by 24
Cheng, Q., Inaba, Y., Lu, P., Xu, M., He, J., Zhao, Y., Guo, G. L., Kuruba, R., de la Vega, R., Evans, R. G., et al. (2015) · Molecular Endocrinology · doi:10.1210/me.2014-1337 · Cited by 22
Mao, J., Chen, X., Wang, C., Li, W., & Li, J. (2020) · Oncology Letters · doi:10.3892/ol.2020.11545 · Cited by 21
“…which FXR suppresses tumor growth remains unclear, but it may involve protecting the colonic epithelium from inflammation and ameliorating BA toxicity by upregulating intracellular BA binding proteins and efflux transporters and downregulating influx transporters and de novo BA synthesis (10-12).”
BackgroundIntestinal failure to produce FGF19: A culprit in intestinal failure–associated liver disease?
van Erpecum, K. J., & Schaap, F. G. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.03.012 · Cited by 22
“For some time, gut microbiota have been appreciated as key determinants of intestinal inflammation and impaired intestinal barrier function, and FXR has recently been implicated in the prevention of intestinal bacterial overgrowth, maintenance of intestinal barrier integrity [7] and pathogenesis of Crohn’s disease [8–…”
BackgroundFXR acts as a therapeutic target for ulcerative colitis via suppressing ferroptosis
Zhao, C., Li, X., Mu, M., Quan, L., Yuan, H., Zheng, J., Zhao, W., Sun, X., & Yu, J. (2025) · Molecular Medicine · doi:10.1186/s10020-025-01305-3 · Cited by 20
“FXR activation not only prevented goblet cell loss and decreased epithelial permeability but also inhibited proinflammatory cytokine secretion in various primary human immune cell types and alleviated NF-kB-medi-ated immune responses in enterocytes (Gadaleta et al. 2011).”
Aldriwesh, M. G., Alotibi, R. S., Alqurainy, N., Alrabiah, S., Arafah, A. M., Alghoribi, M. F., & Ajina, R. (2025) · Gut Microbes · doi:10.1080/19490976.2025.2607076 · Cited by 21
Zhu, Y., Xu, S., Lu, Y., Wei, Y., Yao, B., Guo, F., Zheng, X., Wang, Y., He, Y., Jin, L.-H., et al. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.00590 · Cited by 17
Isidori, M., Corbee, R. J., & Trabalza‐Marinucci, M. (2022) · Veterinary Sciences · doi:10.3390/vetsci9020037 · Cited by 24
“In a murine study, TGR-5 activation by related bile acid ligands suppressed nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB)-mediated inflammatory response following lipopolysaccharide injection in wild-type mice but not in TGR-5 knockout mice [85].”
BackgroundGillard, J., Picalausa, C., Ullmer, C., Adorini, L., Staels, B., Tailleux, A., & Leclercq, I. A. (2022) · Nutrients · doi:10.3390/nu14132707 · Cited by 20
Self-citationLi, Y., Wang, K., Ding, J., Sun, S., Ni, Z., & Yu, C. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.954684 · Cited by 21
The emerging microbiome‐based approaches to IBD therapy: From SCFAs to urolithin A
Rudiansyah, M., Jasim, S. A., Azizov, B., Samusenkov, V. O., Abdelbasset, W. K., Yasin, G., Mohammad, H. J., Jawad, M. A., Mahmudiono, T., Hosseini‐Fard, S. R., et al. (2022) · Journal of Digestive Diseases · doi:10.1111/1751-2980.13131 · Cited by 20
“Activation of BA receptors prevents against experimental colitis, and may also have an anti-inflammatory impact.(161) Mice lacking FXRs have reduced intestinal barrier and decreased antimicrobial protection in the small intestine.”
BackgroundRole of the Gut–Liver Axis in the Pathobiology of Cholangiopathies: Basic and Clinical Evidence
Bragazzi, M. C., Venere, R., Vignone, A., Alvaro, D., & Cardinale, V. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24076660 · Cited by 21
“In addition, FXR activation via OCA represses chemically-induced intestinal inflammation in mice, suggesting the possible role of FXR in inflammatory bowel disease [52].”
BackgroundInfluentialKim, Y., Kim, H.-Y., Jang, J.-T., & Hong, S. (2023) · Molecules · doi:10.3390/molecules28248099 · Cited by 20
“It is composed of enterocytes that are tightly connected through intercellular junctions [8].”
BackgroundLiu, Y., Xiao, Y., Chen, S., Tian, X., Wang, W., Wang, Y., & Cai, W. (2021) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000003135 · Cited by 20
“Enterocyte-like cells differentiated by FXR activation decrease proinflammatory cytokine levels, which might ameliorate intestinal inflammation (16).”
BackgroundMarzano, M., Fosso, B., Colliva, C., Notario, E., Passeri, D., Intranuovo, M., Gioiello, A., Adorini, L., Pesole, G., Pellicciari, R., et al. (2022) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2022.113380 · Cited by 21
Self-citationQian, S., Su, Z., Lin, J., Hou, Q., Wang, X., Li, Y., Wang, J., Huang, C., Wang, Z., Cubero, F. J., et al. (2025) · Cell Communication and Signaling · doi:10.1186/s12964-025-02224-w · Cited by 24
“FXR is a crucial factor in regulating immunity within the gastrointestinal tract and exerts an anti-inflammatory role in DSS-induced colitis [15].”
Bile acid‐activated receptors in innate and adaptive immunity: targeted drugs and biological agents
Cheung, K. C. P., Ma, J., Loiola, R. A., Chen, X., & Jia, W. P. (2023) · European Journal of Immunology · doi:10.1002/eji.202250299 · Cited by 22
Effects of bile acid metabolism on intestinal health of livestock and poultry
Jia, H., & Dong, N. (2024) · Journal of Animal Physiology and Animal Nutrition · doi:10.1111/jpn.13969 · Cited by 19
Roles of Bile Acid-Activated Receptors in Monocytes-Macrophages and Dendritic Cells
Jia, H., He, X., Jiang, T., & Kong, F. (2025) · Cells · doi:10.3390/cells14120920 · Cited by 21
“Gadaleta et al. (2011) demonstrated that activation of FXR by the selective agonist INT-747 can reduce the severity of DSS and TNBS-induced colitis in mice, leading to decreased production of the pro-inflammatory cytokine TNF-α in DCs [50].”
Primary Sclerosing Cholangitis: New Approaches to Diagnosis, Surveillance and Treatment
Trauner, M., Halilbasic, E., Baghdasaryan, A., Moustafa, T., Krones, E., Fickert, P., Hofer, H., & Penner, E. (2012) · Digestive Diseases · doi:10.1159/000341123 · Cited by 20
Therapeutic Role of Bile Acids and Nuclear Receptor Agonists in Fibrosing Cholangiopathies
Trauner, M., Halilbasic, E., Kazemi-Shirazi, L., Kienbacher, C., Staufer, K., Traussnigg, S., & Hofer, H. (2014) · Digestive Diseases · doi:10.1159/000360517 · Cited by 19
Wasinger, V. C., Lu, K., Yau, Y. Y., Nash, J., Lee, J., Chang, J., Paramsothy, S., Kaakoush, N. O., Mitchell, H. M., & Leong, R. W. L. (2020) · Scientific Reports · doi:10.1038/s41598-020-69746-w · Cited by 20
Metadata
- Authors
- Gadaleta, R. M., van Erpecum, K. J., Oldenburg, B., Willemsen, E. C. L., Renooij, W., Murzilli, S., Klomp, L. W. J., Siersema, P. D., Schipper, M. E. I., Danese, S., Penna, G., Laverny, G., Adorini, L., Moschetta, A., & Mil, S. W. C. V.
- Affiliations
- University Medical Center Utrecht (NL)
- Mario Negri Sud Foundation (IT)
- Corresponding author
- Mil, Saskia W C van
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2011-01-17
- Volume
- 60
- Issue
- 4
- Pages
- 463-472
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W2134059673
- Cited by
- 870
- References
- 43
- Citations by year
- 2026: 72 · 2025: 87 · 2024: 95 · 2023: 75 · 2022: 96 · 2021: 84 · 2020: 59 · 2019: 46 · 2018: 35 · 2017: 44 · 2016: 40 · 2015: 36 · 2014: 29 · 2013: 35 · 2012: 21
- FWCI
- 19.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Funders
- Intercept Pharmaceuticals
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Keywords
- farnesoid X receptor, FXR agonists, inflammatory bowel disease, colitis, intestinal barrier function, epithelial permeability, goblet cell loss, inflammatory cytokines, TNF-α, dendritic cells, monocytes, lamina propria, bile salts, DSS-induced colitis
- MeSH terms
- Receptor, Farnesoid X-Activated, Animals, Chenodeoxycholic Acid, Colon, Disease Models, Animal, Drug Evaluation, Preclinical, Gene Expression Regulation, Humans, Ileum, Intestinal Absorption, Mice, Inbred C57BL, Trinitrobenzenesulfonic Acid, Tumor Necrosis Factor-alpha, Inflammatory Bowel Diseases, Cytokines, Dextran Sulfate, Receptors, Cytoplasmic and Nuclear, Inflammation Mediators, Caco-2 Cells, Reverse Transcriptase Polymerase Chain Reaction, Mice
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