Protein / target

Bile acid receptor

NR1H4Q96RI1Homo sapiensSwiss-Prot
Clinically validated
Therapeutic maturity
3
Approved medicines
30
Clinical trials
Small-molecule tractable
Druggability
Approved Drug

Protein at a glance

Biological role

Transcription cis-regulatory region binding

Primary system

Endocrine & metabolic

Strongest disease association

progressive familial intrahepatic cholestasis

Genetic evidence · score 0.81

Therapeutic maturity

Clinically validated target

3 approved medicines against this target

Druggability

Small molecule

Open Targets tractability · Approved Drug

Clinical development

3 approved · 6 in clinical development

30 linked trials

Derived from structured UniProt, Open Targets and literature data on this page.

Protein profile

UniProt 2026_02

Canonical identity and biological annotation from UniProt.

Function

Ligand-activated transcription factor. Receptor for bile acids (BAs) such as chenodeoxycholic acid (CDCA), lithocholic acid, deoxycholic acid (DCA) and allocholic acid (ACA). Plays a essential role in BA homeostasis through the regulation of genes involved in BA synthesis, conjugation and enterohepatic circulation. Also regulates lipid and glucose homeostasis and is involved innate immune response (PubMed:10334992, PubMed:10334993, PubMed:21383957, PubMed:22820415). The FXR-RXR heterodimer binds predominantly to farnesoid X receptor response elements (FXREs) containing two inverted repeats of the consensus sequence 5'-AGGTCA-3' in which the monomers are spaced by 1 nucleotide (IR-1) but also to tandem repeat DR1 sites with lower affinity, and can be activated by either FXR or RXR-specific ligands. It is proposed that monomeric nuclear receptors such as NR5A2/LRH-1 bound to coregulatory nuclear responsive element (NRE) halfsites located in close proximity to FXREs modulate transcriptional activity (By similarity). In the liver activates transcription of the corepressor NR0B2 thereby indirectly inhibiting CYP7A1 and CYP8B1 (involved in BA synthesis) implicating at least in part histone demethylase KDM1A resulting in epigenomic repression, and SLC10A1/NTCP (involved in hepatic uptake of conjugated BAs). Activates transcription of the repressor MAFG (involved in regulation of BA synthesis) (By similarity). Activates transcription of SLC27A5/BACS and BAAT (involved in BA conjugation), ABCB11/BSEP (involved in bile salt export) by directly recruiting histone methyltransferase CARM1, and ABCC2/MRP2 (involved in secretion of conjugated BAs) and ABCB4 (involved in secretion of phosphatidylcholine in the small intestine) (PubMed:12754200, PubMed:15471871, PubMed:17895379). Activates transcription of SLC27A5/BACS and BAAT (involved in BA conjugation), ABCB11/BSEP (involved in bile salt export) by directly recruiting histone methyltransferase CARM1, and ABCC2/MRP2 (involved in secretion of conjugated BAs) and ABCB4 (involved in secretion of phosphatidylcholine in the small intestine) (PubMed:10514450, PubMed:15239098, PubMed:16269519). In the intestine activates FGF19 expression and secretion leading to hepatic CYP7A1 repression (PubMed:12815072, PubMed:19085950). The function also involves the coordinated induction of hepatic KLB/beta-klotho expression (By similarity). Regulates transcription of liver UGT2B4 and SULT2A1 involved in BA detoxification; binding to the UGT2B4 promoter seems to imply a monomeric transactivation independent of RXRA (PubMed:12806625, PubMed:16946559). Modulates lipid homeostasis by activating liver NR0B2/SHP-mediated repression of SREBF1 (involved in de novo lipogenesis), expression of PLTP (involved in HDL formation), SCARB1 (involved in HDL hepatic uptake), APOE, APOC1, APOC4, PPARA (involved in beta-oxidation of fatty acids), VLDLR and SDC1 (involved in the hepatic uptake of LDL and IDL remnants), and inhibiting expression of MTTP (involved in VLDL assembly (PubMed:12554753, PubMed:12660231, PubMed:15337761). Increases expression of APOC2 (promoting lipoprotein lipase activity implicated in triglyceride clearance) (PubMed:11579204). Transrepresses APOA1 involving a monomeric competition with NR2A1 for binding to a DR1 element (PubMed:11927623, PubMed:21804189). Also reduces triglyceride clearance by inhibiting expression of ANGPTL3 and APOC3 (both involved in inhibition of lipoprotein lipase) (PubMed:12891557). Involved in glucose homeostasis by modulating hepatic gluconeogenesis through activation of NR0B2/SHP-mediated repression of respective genes. Modulates glycogen synthesis (inducing phosphorylation of glycogen synthase kinase-3) (By similarity). Modulates glucose-stimulated insulin secretion and is involved in insulin resistance (PubMed:20447400). Involved in intestinal innate immunity. Plays a role in protecting the distal small intestine against bacterial overgrowth and preservation of the epithelial barrier (By similarity). Down-regulates inflammatory cytokine expression in several types of immune cells including macrophages and mononuclear cells (PubMed:21242261). Mediates trans-repression of TLR4-induced cytokine expression; the function seems to require its sumoylation and prevents N-CoR nuclear receptor corepressor clearance from target genes such as IL1B and NOS2 (PubMed:19864602). Involved in the TLR9-mediated protective mechanism in intestinal inflammation. Plays an anti-inflammatory role in liver inflammation; proposed to inhibit pro-inflammatory (but not antiapoptotic) NF-kappa-B signaling) (By similarity)

Subcellular location

Nucleus
Domains and Gene Ontology detail (68)

Domains & features

NR LBD

Gene Ontology

  • Cchromatin
  • Ceuchromatin
  • Cnuclear speck
  • Cnucleoplasm
  • Cnucleus
  • Creceptor complex
  • CRNA polymerase II transcription regulator complex
  • Fbile acid binding
  • Fbile acid nuclear receptor activity
  • Fchenodeoxycholic acid binding
  • FDNA-binding transcription activator activity, RNA polymerase II-specific
  • FDNA-binding transcription factor activity

486 aa · 56 kDa · 5 isoforms

Biological roles

Reactome v97

What this protein does, drawn together from its UniProt function, Gene Ontology terms and Reactome pathways.

Nuclear receptor signallingUniProt · GO · ReactomeTranscriptional regulationUniProt · GO · ReactomeImmune signallingUniProt · GOMetabolic enzyme activityGOKinase signallingUniProtCell adhesionGO
View supporting evidence

Nuclear receptor signalling

  • ·Ligand-activated transcription factor. Receptor for bile acids (BAs) such as chenodeoxyc…
  • ·bile acid nuclear receptor activity
  • ·DNA-binding transcription factor activity
  • ·DNA-binding transcription factor activity, RNA polymerase II-specific

Transcriptional regulation

  • ·Ligand-activated transcription factor. Receptor for bile acids (BAs) such as chenodeoxyc…
  • ·RNA polymerase II transcription regulator complex
  • ·DNA-binding transcription activator activity, RNA polymerase II-specific
  • ·DNA-binding transcription factor activity

Immune signalling

  • ·Ligand-activated transcription factor. Receptor for bile acids (BAs) such as chenodeoxyc…
  • ·inflammatory response
  • ·innate immune response
  • ·negative regulation of inflammatory response

Metabolic enzyme activity

  • ·regulation of cholesterol metabolic process
  • ·regulation of glutamate metabolic process
  • ·urea metabolic process

Kinase signalling

  • ·Ligand-activated transcription factor. Receptor for bile acids (BAs) such as chenodeoxyc…

Cell adhesion

  • ·cell-cell junction assembly
View underlying pathways (8)

Concepts derived from UniProt GO Reactome — each badge above shows which sources supported that role.

Interaction neighbourhood

STRING v12.0

Proteins with the strongest functional or physical association. Node size and line weight reflect STRING confidence; hover or select a partner to inspect one association.

RXRANCOA1GPBAR1XPR1CYP7A1NR0B2NCOR1PPARGC…NCOA2ABCB11NR1H4

10 strongest partners — larger node and heavier line mean higher confidence

Functional and physical associations from STRING v12.0. Only associations with this protein are drawn — partner-to-partner links are not part of this evidence.

Drugs targeting this protein

2

Whether each drug engages this protein directly or through a complex, and how many other targets are recorded for it. Direct binders with few recorded targets are listed first.

Chenodeoxycholic Acid
Narrow target profileAgonist

Bile acid receptor FXR agonist

Direct interaction with this protein · Only this protein recorded as a target

Ursodeoxycholic Acid
Narrow target profileAgonist

Bile acid receptor FXR agonist

Direct interaction with this protein · Only this protein recorded as a target

ChEMBL mechanism, action type and target identity. Open Targets clinical status and indications.

Translational evidence

Open Targets 26

Why this target matters therapeutically — disease associations, drugs in development, tractability and safety, from Open Targets.

Strongest genetic associations

Human genetic evidence — the most direct causal link between this target and a disease.

progressive familial intrahepatic cholestasis0.81

Genetic · overall 0.73

progressive familial intrahepatic cholestasis type 10.76

Genetic · overall 0.48

ciliopathy0.76

Genetic literature · overall 0.46

Highest-confidence therapeutic associations

Diseases where a drug acting on this target has already reached clinical development.

primary biliary cholangitis0.97

Clinical · overall 0.61

biliary liver cirrhosis0.87

Clinical · overall 0.54

cerebrotendinous xanthomatosis0.75

Clinical · overall 0.46

chronic hepatitis C virus infection0.71

Clinical · overall 0.43

cholelithiasis0.61

Clinical · overall 0.38

Highest overall evidence

Remaining associations by Open Targets' aggregated evidence score.

cholangitis0.37

Clinical

inborn errors of metabolism0.37

Clinical

Show all associations
progressive familial intrahepatic cholestasis0.73
primary biliary cholangitis0.61
biliary liver cirrhosis0.54
progressive familial intrahepatic cholestasis type 10.48
ciliopathy0.46
cerebrotendinous xanthomatosis0.46
chronic hepatitis C virus infection0.43
cholelithiasis0.38
cholangitis0.37
inborn errors of metabolism0.37

Open Targets ranks 1,196 associations for this target and we store the top 10 by aggregated score. The long tail is largely literature co-mention and RNA-expression evidence, not evidence that this target drives those diseases.

Known drugs · 9 total

PX-102Phase 2

metabolic dysfunction-associated steatotic liver disease · Hepatic fibrosis

URSODIOLApproval

biliary liver cirrhosis · chronic hepatitis C virus infection · primary biliary cholangitis

TUROFEXORATE ISOPROPYLPhase 1

familial hyperlipidemia

CILOFEXORPhase 3

sclerosing cholangitis · metabolic dysfunction-associated steatohepatitis · metabolic dysfunction-associated steatohepatitis

OBETICHOLIC ACIDApproval

cholangitis · primary biliary cholangitis · primary biliary cholangitis

CHENODIOLApproval

cholelithiasis · inborn errors of metabolism · cerebrotendinous xanthomatosis

TROPIFEXORPhase 2

primary biliary cholangitis · metabolic dysfunction-associated steatohepatitis · Hepatic fibrosis

NIDUFEXORPhase 2

diabetic kidney disease · metabolic dysfunction-associated steatohepatitis · type 2 diabetes mellitus

TERN-101Phase 2

metabolic dysfunction-associated steatohepatitis · metabolic dysfunction-associated steatohepatitis

Tractability

SM · Approved DrugSM · Structure with LigandSM · High-Quality LigandSM · High-Quality PocketSM · Druggable FamilyPR · UniProt UbiquitinationPR · Small Molecule Binder

Safety liabilities

protein stabilizationregulation of transcription factor activityIncreased, Liver Steatosisreceptor binding

Clinical trials

30

Trials of drugs that target this protein — reached indirectly through those drugs, so a trial listed here studies the drug, not the protein.

Show remaining trials (24)

COMPLETED · via Ursodeoxycholic Acid · NCT00846963

WITHDRAWN · via Chenodeoxycholic Acid · NCT00018694

COMPLETED · via Chenodeoxycholic Acid · NCT03168555

ClinicalTrials.gov via the drug-target graph.

Forefront confidence

Synthesis

Our own weighting of the evidence behind each disease association. Human genetics and clinical evidence count for most; literature co-mention counts for little, because two entities sharing an abstract is not evidence that one drives the other.

progressive familial intrahepatic cholestasisWell supported
0.86
agreement 0.740.98
Genetic76%Animal model22%Literature2%Genetic literaturedup

Open Targets aggregate 0.73 · 3 independent evidence families · 1 not counted as duplicate

progressive familial intrahepatic cholestasis type 1Well supported
0.81
agreement 0.690.93
Genetic80%Animal model19%Literature1%

Open Targets aggregate 0.48 · 3 independent evidence families

primary biliary cholangitisWell supported
0.79
agreement 0.670.92
Clinical73%Animal model18%Literature9%

Open Targets aggregate 0.61 · 3 independent evidence families

biliary liver cirrhosisModerately supported
0.72
agreement 0.590.85
Clinical77%Animal model21%Literature2%

Open Targets aggregate 0.54 · 3 independent evidence families

ciliopathyModerately supported
0.61
agreement 0.460.76
Genetic literature99%Literature1%

Open Targets aggregate 0.46 · 2 independent evidence families

The evidence agreement range shows how closely the independent evidence families agree — it is not a statistical confidence interval, and nothing here is fitted to outcome data. Derived from Open Targets evidence types under Forefront weighting; the underlying per-type scores are shown above so the calculation can be checked.

What's happening now

4

Recent activity around this target, drawn from one canonical event stream. Every item is reached through 2 drugs that target this protein, so each event is news about that drug rather than about the protein directly.

  1. New publication2020-05-11
    A dysregulated bile acid-gut microbiota axis contributes to obesity susceptibility.

    EBioMedicine · 2020 · 194 citations · Europe PMC · via Chenodeoxycholic Acid

  2. New publication2019-10-31
    Theabrownin from Pu-erh tea attenuates hypercholesterolemia via modulation of gut microbiota and bile acid metabolism.

    Nature communications · 2019 · 549 citations · Europe PMC · via Chenodeoxycholic Acid

  3. New publication2019-10-09
    Diversification of host bile acids by members of the gut microbiota.

    Gut microbes · 2020 · 415 citations · Europe PMC · via Ursodeoxycholic Acid

  4. Regulatory approval2017-04-10

    Approval: Chenodeoxycholic acid Leadiant (previously Chenodeoxycholic acid sigma-tau) (EMA)

    ema · regulatory · ema · via Chenodeoxycholic Acid

Objective event titles are shown unmodified; the event kind and significance line are derived from structured fields. Forefront AttentionEvent stream aggregating Europe PMC Regulatory filings ClinicalTrials.gov.