Bile acids lead to dysfunction of farnesoid X receptor, liver X receptor, pregnane X receptors, and/or G-protein-coupled receptor TGR5, which are involved in a variety of metabolic and hepatic functions.18 Excess bile acids accumulation leads to, in order of increasing severity in liver dysfunction, acute oxidative stress, necroinflammation, fibrosis, cirrhosis, and end-stage liver failure. This evidence concerns the gene NR1H4 and Cirrhosis.