Bile acid signaling: Mechanism for bariatric surgery, cure for NASH?

Rohit Kohli, Andriy Myronovych, Brandon K. Tan, Rosa Maria Salazar-Gonzalez, Lili Miles, Wujuan Zhang, Melissa Oehrle, Darleen A. Sandoval, Karen K. Ryan, Randy J. Seeley, Kenneth D.R. Setchell

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Bariatric surgery is the most effective and durable treatment option for obesity today. More importantly, beyond weight loss, bariatric procedures have many advantageous metabolic effects including reversal of obesity-related liver disease - nonalcoholic steatohepatitis (NASH). NASH is an important comorbidity of obesity given that it is a precursor to the development of liver cirrhosis that may necessitate liver transplantation in the long run. Simultaneously, we and others have observed increased serum bile acids in humans and animals that undergo bariatric surgery. Specifically, our preclinical studies have included experimental procedures such as 'ileal transposition' or bile diversion and established procedures such as Roux-en-Y gastric bypass and the adjustable gastric band. Importantly, these effects are not simply the result of weight loss since our data show that the resolution of NASH and increase in serum bile acids are not seen in rodents that lose an equivalent amount of weight via food restriction. In particular, we have studied the role of altered bile acid signaling, in the potent impact of a bariatric procedure termed 'vertical sleeve gastrectomy' (VSG). In this review we focus on the mechanisms of NASH resolution and weight loss after VSG surgery. We highlight the fact that bariatric surgeries can be used as 'laboratories' to dissect the mechanisms by which these procedures work to improve obesity and fatty liver disease.

Original languageEnglish
Pages (from-to)440-446
Number of pages7
JournalDigestive Diseases
Issue number3
StatePublished - Jun 9 2015


  • Bariatric surgery
  • Bile acid metabolism
  • Nonalcoholic fatty liver disease
  • Obesity


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