NR1H4 and Cowden disease: BA can influence the mucosal barrier integrity, and perform antimicrobial activity by inducing genes that encode anti-bacterial peptides and lectins via farnesoid X receptor (FXR).45 Alteration in BA metabolism can cause membrane damage to both microbial cells and the intestinal barrier, and impair the development of colonic RORγ+ regulatory T cells thereby promoting intestinal inflammation.46,47 Taken together, our data indicate that gut microbiota dysbiosis may contribute to the inflammation and mucosal barrier damage in CD by altering the intestinal metabolome.