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. 2020 Nov 30;12(5):411–425. doi: 10.1007/s13238-020-00804-9

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© The Author(s) 2020

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Alternative BA synthetic pathway manipulated by gut microbiota. (1) Gut bacteria express 7-hydroxysteroid dehydrogenase (7-HSDH) which catalyzes the epimerization of BA 7-hydroxyl groups and converts the primary non-12-OH BA (CDCA) to UDCA. (2) Non-12-OH BAs can be produced by a non-bacteria metabolic process. (3) Gut bacterial species might also express 12α-dehydroxylase activity, which would convert 12-OH BAs to non-12-OH BAs. The activation of the alternative pathway accelerates BA circulation and fecal excretion and suppresses hepatic cholesterol and lipid metabolism