BSEP inhibition can lead to a decrease in bile flow (i.e., cholestasis) in the biliary tree that is BA-dependent, but the pattern of liver injury associated with reduced BSEP-mediated biliary excretion and the resultant accumulation of BAs often presents itself as hepatocellular (i.e., primarily involving hepatocytes as the injured cell type, which by convention is defined as ALT > 5x ULN, or when ALT/ALP (fold ULN) > 5 (Yang et al., 2013; Church and Watkins, 2021)). This evidence concerns the gene GPT and cholestasis.