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Protein / target

Bile acid receptor

Encoded byNR1H4Q96RI1Homo sapiensSwiss-Prot
Clinically validated
Therapeutic maturity
3
Approved medicines
Open Targets target-level
View by indication →
30
Clinical trials
Small-molecule tractable
Druggability
Approved Drug

Protein at a glance

Biological role

Transcription cis-regulatory region binding

Strongest disease association

Progressive familial intrahepatic cholestasis

Via encoding gene NR1H4 · Genetic evidence · score 0.81

Therapeutic position

Established drug target

Small molecules

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 overview

Ligand-activated transcription factor.

View complete UniProt function annotation

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.

Lipid & lipoprotein metabolismUniProt · GO · ReactomeNuclear receptor signallingUniProt · GO · ReactomeTranscriptional regulationUniProt · GO · ReactomeImmune signallingUniProt · GO
View supporting evidence

Lipid & lipoprotein metabolism

  • ·Ligand-activated transcription factor. Receptor for bile acids (BAs) such as chenodeoxyc…
  • ·cellular response to fatty acid
  • ·cholesterol homeostasis
  • ·fatty acid homeostasis

Nuclear receptor signalling

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

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
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.

Approved medicines with mapped indications

3 medicines · 3 areas

Approved therapies targeting this protein, grouped by what they are approved to treat — the disease-first view of the medicines below. Relationships come from the canonical approved-indication graph (ChEMBL phase-4), the same source as the drug cards.

Liver Cirrhosis, Biliary2 medicines
Cholangitis1 medicine
Metabolism, Inborn Errors1 medicine

Approved indications from ChEMBL (phase-4), via the canonical drug→disease graph.

Drugs targeting this protein

3

How approved and investigational drugs engage this protein — mechanism and action type, direct vs complex targeting, and how broadly each acts across other targets. A drug-first view (the section above groups the approved ones disease-first); direct binders with few recorded targets are listed first.

Chenodeoxycholic Acid
Narrow target profileAgonist

Bile acid receptor FXR agonist

Indicated for Metabolism, Inborn Errors

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

Ursodeoxycholic Acid
Narrow target profileAgonist

Bile acid receptor FXR agonist

Indicated for Liver Cirrhosis, Biliary

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

obeticholic acid
Narrow target profileApprovedAgonist

Bile acid receptor FXR agonist

Indicated for Cholangitis, Liver Cirrhosis, Biliary

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

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

Translational evidence

Open Targets 26

Why this target matters therapeutically, strongest evidence first. Disease associations are gene-level (via the gene that encodes this protein) and open into the full confidence synthesis; the development universe, tractability and safety annotations are target-level, from Open Targets.

Strongest disease associations · via encoding gene NR1H4

Gene-level evidence surfaced through the gene NR1H4that encodes this protein — not a direct protein–disease relationship. Ranked by Forefront's causal-directness weighting, so genetically- and clinically-evidenced diseases lead over ones that merely share the literature.

Progressive familial intrahepatic cholestasis
0.86Well supported

Genetic evidence dominant · Open Targets 0.73

Progressive familial intrahepatic cholestasis type 1
0.81Well supported

Genetic evidence dominant · Open Targets 0.48

Primary biliary cholangitis
0.79Well supported

Clinical evidence dominant · Open Targets 0.61

Biliary liver cirrhosis
0.72Moderately supported

Clinical evidence dominant · Open Targets 0.54

Ciliopathy
0.61Moderately supported

Genetic literature evidence dominant · Open Targets 0.46

View evidence synthesis (5)
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 per-type scores above show the calculation.

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
Hepatitis C, Chronic0.43
Cholelithiasis0.38
Cholangitis0.37

Drug development

9 compounds recorded · 3 approved · 6 in clinical development

Open Targets' development universe — every compound recorded against the target at any stage, not all approved medicines. Distinct from the 3 drugs that target this protein in Forefront's canonical graph (3 with a mapped approved indication, shown above): these count different sets and are not a subset relation.

View all recorded compounds (9)
PX-102Phase 2
URSODIOLApproval
TUROFEXORATE ISOPROPYLPhase 1
CILOFEXORPhase 3
OBETICHOLIC ACIDApproval
CHENODIOLApproval
TROPIFEXORPhase 2
NIDUFEXORPhase 2
TERN-101Phase 2

Open Targets known-drugs universe. Drug name and highest clinical stage only — the disease relationship is NOT read from this slice (it carries trial-context noise); approved indications come from the canonical graph above.

Tractability

Small moleculesStrong

Approved Drug and Structure with Ligand support this modality.

Protein degradersEmerging

Feasibility evidence (uniprot ubiquitination and small molecule binder) — no clinical-stage drug of this modality recorded.

View underlying tractability evidence (7)
SM · Approved DrugSM · Structure with LigandSM · High-Quality LigandSM · High-Quality PocketSM · Druggable FamilyPR · UniProt UbiquitinationPR · Small Molecule Binder

Raw Open Targets tractability assessment buckets, by modality.

Safety-related annotations

protein stabilizationToxCastregulation of transcription factor activityToxCastIncreased, Liver SteatosisAOP-Wikireceptor bindingToxCast

Terms indexed against this target in Open Targets' safety data, with their datasource. These are annotations, not causal claims: the direction of effect (whether activation or inhibition is implicated), species and evidence strength are not captured here, so an entry does not mean that modulating this target is known to cause that condition.

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. Ranked by active status, then clinical phase and recency, and spread across the targeting drugs.

View all trials (26)

ACTIVE_NOT_RECRUITING · via Ursodeoxycholic Acid · NCT06174402

RECRUITING · via obeticholic acid · NCT04939051

ClinicalTrials.gov via the drug-target graph.

What's happening now

6

Recent therapeutic activity around this target — regulatory actions, clinical trials and safety signals for 3 drugs that target this protein, plus publications where such a drug is a genuine subject. Every item is reached indirectly through the drug, not the protein itself; incidental mentions (a paper that merely measures a drug) and press items are excluded.

  1. Withdrawn from market2024-08-30

    Market withdrawal: Ocaliva (EMA)

    ema · market · ema · via obeticholic acid

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

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

  3. 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

  4. 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

  5. Safety communication2018-04-24

    Drug Safety Update: Obeticholic acid (Ocaliva▼): risk of serious liver injury in patients with pre-existing moderate or severe hepatic impairment; reminder to adjust dosing according to liver function monitoring

    mhra · safety · mhra · via obeticholic acid

  6. 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.