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Letter to the Editor: Could Butyrate Be Incorporated With Farnesoid X Receptor Agonist Cilofexor to Enhance Primary Sclerosing Cholangitis Treatment?

Primary sclerosing cholangitis (PSC) is characterized by chronic liver inflammation and cholestasis due to intrahepatic and extrahepatic bile duct inflammation and fibrosis. Cholestasis results in accumulation of bile acids in the liver with a concomitant deficit in the intestines. Accumulation of bile acids could be causal for inflammation of the liver, whereas deficiency of bile acids in the intestines could result in insufficient deoxycholic acid (DCA) in both the intestines and the liver, leading to decreased activation of intestinal farnesoid X receptor (FXR).