Considering the intricate interplay between FXR and the microbiota, Shu and team found that berberine alleviates NASH by regulating the interplay between the gut microbiome-manifested through increased relative abundance of Clostridium, Lactobacillus, and Phytodermidae- and BA metabolism, along with activating gut FXR [89]. Here, NR1H4 is linked to metabolic dysfunction-associated steatohepatitis.