The human microbiome and bile acid metabolism: Dysbiosis, dysmetabolism, disease and intervention
Abstract
INTRODUCTION: Recent evidence indicates that the human gut microbiome plays a significant role in health and disease. Dysbiosis, defined as a pathological imbalance in a microbial community, is becoming increasingly appreciated as a 'central environmental factor' that is both associated with complex phenotypes and affected by host genetics, diet and antibiotic use. More recently, a link has been established between the dysmetabolism of bile acids (BAs) in the gut to dysbiosis. AREAS COVERED: BAs, which are transformed by the gut microbiota, have been shown to regulate intestinal homeostasis and are recognized as signaling molecules in a wide range of metabolic processes. This review will examine the connection between BA metabolism as it relates to the gut microbiome and its implication in health and disease. EXPERT OPINION: A disrupted gut microbiome, including a reduction of bile salt hydrolase (BSH)-active bacteria, can significantly impair the metabolism of BAs and may result in an inability to maintain glucose homeostasis as well as normal cholesterol breakdown and excretion. To better understand the link between dysbiosis, BA dysmetabolism and chronic degenerative disease, large-scale metagenomic sequencing studies, metatranscriptomics, metaproteomics and metabolomics should continue to catalog functional diversity in the gastrointestinal tract of both healthy and diseased populations. Further, BSH-active probiotics should continue to be explored as treatment options to help restore metabolic levels.
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Chenodeoxycholic acid (CDCA) is the major activator of FXR, followed by deoxycholic acid (DCA), colic acid (LCA), and cholic acid (CA).
“Chenodeoxycholic acid (CDCA) is the major activator of FXR, followed by deoxycholic acid (DCA), colic acid (LCA), and cholic acid (CA) (Jones et al., 2014).”
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 Jones et al., 2014
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ComPPARtmentalizing NF-κB in the gut
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Bile acid signaling in metabolic disease and drug therapy
Li, T., & Chiang, J. Y. L. (2014) · Pharmacological Reviews · doi:10.1124/pr.113.008201 · Cited by 935 · see citing works
“Dysbiosis is the major environmental factor that affects bile acid metabolism and contributes to diseases not only in the gastrointestinal system but also in chronic diseases, such as NAFLD, diabetes, and obesity (Jones et al., 2014).”
BackgroundIntestinal transport and metabolism of bile acids
Dawson, P. A., & Karpen, S. J. (2015) · Journal of Lipid Research · doi:10.1194/jlr.r054114 · Cited by 598 · see citing works
The Human Microbiome and Obesity: Moving beyond Associations
Maruvada, P., Leone, V., Kaplan, L. M., & Chang, E. B. (2017) · Cell Host & Microbe · doi:10.1016/j.chom.2017.10.005 · Cited by 468 · see citing works
Molecular cartography of the human skin surface in 3D
Bouslimani, A., Porto, C., Rath, C. M. B., Wang, M., Guo, Y., González, A., Berg-Lyons, D., Ackermann, G. L., Christensen, G. J. M., Nakatsuji, T., et al. (2015) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1424409112 · Cited by 353 · see citing works
“Cholic acids, commonly described as bile acids, are important players of the lipid metabolism in the gut and help maintain a healthy gut microbial community, thus representing a viable therapeutic intervention against pathogens (29).”
BackgroundReijnders, D., Goossens, G. H., Hermes, G. D. A., Neis, E. P. J. G., van der Beek, C. M., Most, J., Holst, J. J., Lenaerts, K., Kootte, R. S., Nieuwdorp, M., et al. (2016) · Cell Metabolism · doi:10.1016/j.cmet.2016.06.016 · Cited by 351 · see citing works
“Although BAs and SCFAs may control incretin release (Brighton et al., 2015; Canfora et al., 2015) and affect energy metabolism in rodents (Gao et al., 2009), no effects on postprandial energy and substrate metabolism and fasting and postprandial glucagon-like peptide 1 (GLP-1) concentrations were found in the present…”
BackgroundResultInfluentialThe gut microbiota and gastrointestinal surgery
Guyton, K. L., & Alverdy, J. C. (2016) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2016.139 · Cited by 225 · see citing works
Duttaroy, A. K. (2021) · Nutrients · doi:10.3390/nu13010144 · Cited by 232 · see citing works
“Recently, the bidirectional relationship between gut microbiota and bile acid metabolism [87] in CVD has been reviewed [48].”
BackgroundThe Role of Gut Microbiota in Atherosclerosis and Hypertension
Ma, J., & Li, H. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2018.01082 · Cited by 226 · see citing works
Sarafian, M. H., Lewis, M. R., Pechlivanis, A., Ralphs, S., McPhail, M. J. W., Patel, V., Dumas, M., Holmes, E. C., & Nicholson, J. K. (2015) · Analytical Chemistry · doi:10.1021/acs.analchem.5b01556 · Cited by 215 · see citing works
Bridging the Gap between Gut Microbial Dysbiosis and Cardiovascular Diseases
Lau, K., Srivatsav, V., Rizwan, A., Nashed, A., Liu, R., Shen, R. D., & Akhtar, M. (2017) · Nutrients · doi:10.3390/nu9080859 · Cited by 214 · see citing works
“Primary BAs are synthesized from cholesterol in the liver, and are excreted into the small intestine to aid lipid emulsification [54].”
BackgroundInfluentialThe gastrointestinal microbiota and colorectal cancer
Keku, T. O., Dulal, S., Deveaux, A. E., Jovov, B., & Han, X. (2014) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00360.2012 · Cited by 205 · see citing works
“The intestinal bacteria are essential in digestion and absorption of indigestible carbohydrates (fibers), production of vitamins B and K, metabolism of endogenous and exogenous compounds, immune potentiation, are actively involved in innate and cell-mediated immunity, help to maintain intestinal barrier function, and…”
BackgroundJoyce, S. A., Kamil, A., Fleige, L. E., & Gahan, C. G. M. (2019) · Frontiers in Nutrition · doi:10.3389/fnut.2019.00171 · Cited by 203 · see citing works
Ma, S., Tong, Q., Lin, Y., Pan, L., Fu, J., Peng, R., Zhang, X., Zhao, Z., Li, Y., Yu, J., et al. (2022) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-022-01027-6 · Cited by 193 · see citing works
Palau‐Rodriguez, M., Tulipani, S., Queipo‐Ortuño, M. I., Urpí-Sardà, M., Tinahones, F. J., & Andrés‐Lacueva, C. (2015) · Frontiers in Microbiology · doi:10.3389/fmicb.2015.01151 · Cited by 159 · see citing works
“Furthermore, according to Jones et al. (2014) Actinobacteria and Firmicutes clones would be the only ones able to degrade all conjugated BA, with Bacteroidetes species being limited to tauro- conjugation activities.”
BackgroundMetabolomic Profiling of Bile Acids in Clinical and Experimental Samples of Alzheimer’s Disease
Pan, X., Elliott, C. T., McGuinness, B., Passmore, P., Kehoe, P. G., Hölscher, C., McClean, P. L., Graham, S. F., & Green, B. D. (2017) · Metabolites · doi:10.3390/metabo7020028 · Cited by 153 · see citing works
“Conditions such as dysbiosis (pathological imbalance in a microbial community) can significantly impair the metabolism of bile acids and may result in an inability to maintain glucose homeostasis as well as normal cholesterol breakdown and excretion [27].”
BackgroundEffects of underfeeding and oral vancomycin on gut microbiome and nutrient absorption in humans
Basolo, A., Hohenadel, M. G., Ang, Q. Y., Piaggi, P., Heinitz, S., Walter, M. F., Walter, P. J., Parrington, S., Trinidad, D., von Schwartzenberg, R. J., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0801-z · Cited by 142 · see citing works
Gadaleta, R. M., García‐Irigoyen, O., Cariello, M., Scialpi, N., Peres, C., Vetrano, S., Fiorino, G., Danese, S., Ko, B., Luo, J., et al. (2020) · EBioMedicine · doi:10.1016/j.ebiom.2020.102719 · Cited by 125 · see citing works
Torres, J., Palmela, C., Brito, H., Bao, X., Ruiqi, H., Moura-Santos, P., da Silva, J. P., Oliveira, A. A. S., Vieira, C. L., Pérez, K., et al. (2017) · United European Gastroenterology Journal · doi:10.1177/2050640617708953 · Cited by 121 · see citing works
Alphonse, P. A. S., & Jones, P. J. H. (2015) · Lipids · doi:10.1007/s11745-015-4096-7 · Cited by 116 · see citing works
“Alters absorption and synthesis [110, 111, 211]”
BackgroundThe Skin-Mucus Microbial Community of Farmed Atlantic Salmon (Salmo salar)
Minniti, G., Hagen, L. H., Porcellato, D., Jørgensen, S. M., Pope, P. B., & Vaaje‐Kolstad, G. (2017) · Frontiers in Microbiology · doi:10.3389/fmicb.2017.02043 · Cited by 114 · see citing works
“These practices could potentially affect the balance of the fish-skin microbiome and reduce the bacterial biodiversity, promoting proliferation of opportunistic bacteria, a process well documented in mammals (Myers, 2004; Jones et al., 2014; Tomasello et al., 2016).”
BackgroundProbiotics ameliorate intestinal pathophysiology in a mouse model of Alzheimer’s disease
Kaur, H., Nagamoto‐Combs, K., Golovko, S. A., Golovko, M. Y., Klug, M. G., & Combs, C. K. (2020) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2020.04.009 · Cited by 112 · see citing works
“Gut microbiota composition can modify the bile acid profile through a broad range of reactions including conjugation and deconjugation resulting in formation of secondary bile acids (Duboc et al., 2013; Jones et al., 2014; Musso et al., 2011; Ridlon et al., 2014; Theriot et al., 2014).”
BackgroundThe Biofilm Community: Rebels with a Cause
Aruni, W., Dou, Y., Mishra, A., & Fletcher, H. M. (2015) · Current Oral Health Reports · doi:10.1007/s40496-014-0044-5 · Cited by 108 · see citing works
Factors Determining Colorectal Cancer: The Role of the Intestinal Microbiota
Nistal, E., Fernández-Fernández, N., Vivas, S., & Olcoz, J. L. (2015) · Frontiers in Oncology · doi:10.3389/fonc.2015.00220 · Cited by 107 · see citing works
Chemoproteomic Profiling of Bile Acid Interacting Proteins
Zhuang, S., Li, Q., Cai, L., Wang, C., & Lei, X. (2017) · ACS Central Science · doi:10.1021/acscentsci.7b00134 · Cited by 105 · see citing works
Determining Microbial Products and Identifying Molecular Targets in the Human Microbiome
Cordy, R. J., Yasuda, K., Shafquat, A., Morgan, X. C., & Huttenhower, C. (2014) · Cell Metabolism · doi:10.1016/j.cmet.2014.10.003 · Cited by 100 · see citing works
“Microbial alteration of bile acids plays a key role in the digestion and absorption of lipids, as well as in glucose homeostasis (Jones et al., 2014).”
BackgroundYuan, B., Zhu, Q., Guo, N., Zheng, S.-J., Wang, Y., Wang, J., Xu, J., Liu, S., He, K. F., Hu, T., et al. (2018) · Analytical Chemistry · doi:10.1021/acs.analchem.7b05355 · Cited by 97 · see citing works
Microbiome-mediated bile acid modification: Role in intestinal drug absorption and metabolism
Enright, E. F., Griffin, B. T., Gahan, C. G. M., & Joyce, S. A. (2018) · Pharmacological Research · doi:10.1016/j.phrs.2018.04.009 · Cited by 86 · see citing works
Functional proteomics within the genus Lactobacillus
Angelis, M. D., Calasso, M. P., Cavallo, N., Cagno, R. D., & Gobbetti, M. (2016) · PROTEOMICS · doi:10.1002/pmic.201500117 · Cited by 86 · see citing works
“Recently, metaproteomics approaches were also proposed to determine the microbial effects on the human health and disease state [79,80,83].”
BackgroundDetection technologies and metabolic profiling of bile acids: a comprehensive review
Liu, Y., Rong, Z., Xiang, D., Zhang, C., & Liu, D. (2018) · Lipids in Health and Disease · doi:10.1186/s12944-018-0774-9 · Cited by 78 · see citing works
“In turn, liver and intestinal diseases are often accompanied by systemic cycling disorders of BAs [3, 4], so their characteristics in blood and tissues can indirectly indicate disease states.”
Davoren, M. J., Liu, J., Castellanos, J. A., Rodriguez-Malave, N. I., & Schiestl, R. H. (2018) · Gut Microbes · doi:10.1080/19490976.2018.1547612 · Cited by 75 · see citing works
Multidomain analyses of a longitudinal human microbiome intestinal cleanout perturbation experiment
Fukuyama, J., Rumker, L., Sankaran, K., Jeganathan, P., Dethlefsen, L., Relman, D. A., & Holmes, S. (2017) · PLoS Computational Biology · doi:10.1371/journal.pcbi.1005706 · Cited by 74 · see citing works
“The provisioning of these and many other compounds are recognized as ecosystem services of the gut microbiota, with health effects both locally in the gut and systemically throughout the host [87, 88].”
BackgroundInterplay Between the Host, the Human Microbiome, and Drug Metabolism
Nichols, R. G., Peters, J. M., & Patterson, A. D. (2019) · Human Genomics · doi:10.1186/s40246-019-0211-9 · Cited by 73 · see citing works
Parenteral Nutrition-Associated Liver Disease: The Role of the Gut Microbiota
Cahová, M., Brátová, M., & Wohl, P. (2017) · Nutrients · doi:10.3390/nu9090987 · Cited by 71 · see citing works
“However, FXR and TGR5 have different affinities to individual BAs, as FXR is activated by CDCA > DCA > LCA >> CA and TGR5 is activated by LCA > DCA > CDCA > CA [78].”
BackgroundLiu, Z., Liu, W., Ran, C., Hu, J., & Zhou, Z. (2016) · Scientific Reports · doi:10.1038/srep23214 · Cited by 69 · see citing works
“Recent research has proven that gut microbes also modulate bile acid synthesis through depression of the nuclear receptor farnesoid X (FXR) pathway 35 , which negatively regulates bile acid synthesis 36 in the ileum and liver.”
Bile Salt Hydrolase-Competent Probiotics in the Management of IBD: Unlocking the “Bile Acid Code”
Gadaleta, R. M., Cariello, M., Crudele, L., & Moschetta, A. (2022) · Nutrients · doi:10.3390/nu14153212 · Cited by 67 · see citing works
Gut Microbiota Modulation as a Novel Therapeutic Strategy in Cardiometabolic Diseases
Mutalub, Y. B., Abdulwahab, M., Mohammed, A., Yahkub, A. M., Al-Mhanna, S. B., Yusof, W., Tang, S. P., Rasool, A. H. G., & Mokhtar, S. S. (2022) · Foods · doi:10.3390/foods11172575 · Cited by 60 · see citing works
Bacterial bile salt hydrolase: an intestinal microbiome target for enhanced animal health
Geng, W., & Lin, J. (2016) · Animal Health Research Reviews · doi:10.1017/s1466252316000153 · Cited by 60 · see citing works
“…host, intestinal BSH plays an important role in host metabolism and energy harvest; BSH activity has significant impacts on host physiology by disturbing conjugated bile acid-mediated fat metabolism and endocrine functions (Begley et al., 2006; Patel et al., 2010; Jones et al., 2014; Joyce et al.,”
BackgroundBile signalling promotes chronic respiratory infections and antibiotic tolerance
Reen, F. J., Flynn, S., Woods, D. F., Dunphy, N., Chróinín, M. N., Mullane, D., Stick, S. M., Adams, C., & O’Gara, F. (2016) · Scientific Reports · doi:10.1038/srep29768 · Cited by 58 · see citing works
“6) is consistent with the emergence of bile acids as mediators of a broad range of human diseases 51 .”
Yang, Y., & Wu, C. (2022) · Food & Function · doi:10.1039/d2fo01252a · Cited by 57 · see citing works
Zhang, Y., Xie, Q., You, L., Cheung, P. C. K., & Zhao, Z. (2021) · eFood · doi:10.2991/efood.k.210310.001 · Cited by 55 · see citing works
Spatz, M., Ciocan, D. M., Merlen, G., Rainteau, D. P., Humbert, L., Gomes-Rochette, N. F., Hugot, C., Trainel, N., Mercier‐Nomé, F., Domenichini, S., et al. (2021) · JHEP Reports · doi:10.1016/j.jhepr.2021.100230 · Cited by 54 · see citing works
Temperature modulation alters the gut and skin microbial profiles of chum salmon (Oncorhynchus keta)
Ghosh, S. K., Wong, M. K., Hyodo, S., Goto, S., & Hamasaki, K. (2022) · Frontiers in Marine Science · doi:10.3389/fmars.2022.1027621 · Cited by 54 · see citing works
Sagar, N., Duboc, H., Kay, G. L., Alam, M. T., Wicaksono, A. N., Covington, J. A., Quince, C., Kokkorou, M., Svolos, V., Palmieri, L., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-77374-7 · Cited by 55 · see citing works
The immunity–diet–microbiota axis in the development of metabolic syndrome
Brandsma, E. T., Houben, T., Fu, J., Shiri‐Sverdlov, R., & Hofker, M. H. (2015) · Current Opinion in Lipidology · doi:10.1097/mol.0000000000000154 · Cited by 50 · see citing works
“In addition, the microbiota affect the composition of the bile acid pool by 7-a/7-b dehydroxylation, desulfation and dehydrogenation, leading to the formation of secondary bile acids, such as deoxycholic acid, lithocholic acid, and tauro-beta-muricholic acid [43].”
Dilworth, L., Riley, C. K., & Stennett, D. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-802104-0.00005-6 · Cited by 50 · see citing works
Zhang, Y., Yang, L., Zhao, N., Hong, Z., Cai, B., Le, Q., Yang, T., Shi, L., & He, J. (2021) · Marine Drugs · doi:10.3390/md19120699 · Cited by 50 · see citing works
“Since a lower F/B ratio was observed in lean i dividuals when compared to their obese counterparts in mice and humans [16], our data indicated the beneficial effect of LJP with respect to obesity.”
MethodResultInfluentialBerbée, J. F. P., Mol, I. M., Milne, G. L., Pollock, E. D., Hoeke, G., Lütjohann, D., Monaco, C. G., Rensen, P. C. N., der Ploeg, L. H. T. V., & Shchepinov, M. S. (2017) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2017.06.916 · Cited by 48 · see citing works
“Potential mechanism(s) may include modulation of the gut microbiome and/or bile acid metabolism in the gut [35,36], and modulation of (local) immune cells [37,38].”
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“…for these results would be that the inactivation in alkaline conditions promoted changes in binding sites of specific cell components preventing their bind to cholesterol or action on the conjugated bile salts that were less excreted in the faeces than in the other groups (Jones et al. 2014).”
BackgroundVascular Cognitive Impairment and the Gut Microbiota
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“The intestinal immune functions and barrier are regulated by bile acid transformation and receptor activation; therefore, gut dysbiosis is associated with altered bile acid metabolism and inflammation [47].”
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“VDR can be activated by LCA; the degree of activation is largely influenced by the GM (Jones et al., 2014).”
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A sequence symmetry analysis of the interrelationships between statins, diabetes and skin infections
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OBESIDADE E SUA RELAÇÃO COM A MICROBIOTA INTESTINAL
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“Dysbiosis of gut microbiota, characterised by ʻ imbalance ’ due to changes in community members or in relative abundance of microbes (Messer and Chang 2018), has also been proven to contribute to the development of atherosclerosis (Jones et al. 2014).”
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The Role of Diet in Shaping Gut Microbiota and Its Impact on Host Metabolic Regulation
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“Consequently, fewer metabolic functions are available, increasing the risk of loss of host homeostasis (Figure 3) [60].”
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- Authors
- Jones, M. L., Martoni, C. J., Ganopolsky, J. G., Labbé, A., & Prakash, S.
- Affiliations
- Micropharma (Canada) (CA)
- Venue
- Expert Opinion on Biological Therapy
- Publisher
- Informa UK Limited
- Published
- 2014-01-30
- Volume
- 14
- Issue
- 4
- Pages
- 467-482
- ISSN
- 1471-2598 (ISSN-L)
- 1744-7682
- OpenAlex
- W2014099400
- Cited by
- 150
- References
- 128
- Citations by year
- 2026: 13 · 2025: 5 · 2024: 8 · 2023: 9 · 2022: 17 · 2021: 20 · 2020: 10 · 2019: 12 · 2018: 12 · 2017: 14 · 2016: 11 · 2015: 12 · 2014: 7
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Opinion on Biological Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- gut microbiota, bile acid metabolism, dysbiosis, bile salt hydrolase, probiotics, glucose homeostasis, cholesterol metabolism, intestinal homeostasis, chronic degenerative diseases, metagenomics, metaproteomics, metabolomics
- MeSH terms
- Animals, Bile Acids and Salts, Diabetes Mellitus, Type 2, Female, Gastrointestinal Diseases, Health Status, Humans, Male, Metabolic Diseases, Obesity, Osteoporosis, Probiotics, Atherosclerosis, Microbiota, Dysbiosis
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