56,57 BAs act as signaling molecules by interacting with the Farnesoid X receptor and G-protein coupled BA receptor 1.58,59 BA homeostasis is disturbed by dysbiosis, altering the BA pool, which in turn may further increase dysbiosis.60,61 How dysbiosis-driven alterations of BA profiles affect hepatobiliary health is a subject of current investigation. BAs affect cellular phenotype and both immune signaling molecules and effectors. Alterations to the BA pool and Farnesoid X receptor expression levels have been observed in case-control studies of HCC, gall bladder cancer, and CCA.62–66. Here, NR1H4 is linked to hepatocellular carcinoma.