OCA, a highly potent semi-synthetic FXR agonist, has been approved by the FDA and the EU for treating primary biliary cholangitis and a phase III clinical study has demonstrated that high-dose OCA improves steatohepatitis and liver fibrosis in NASH patients (Nevens et al., 2016; Younossi et al., 2019). Here, NR1H4 is linked to metabolic dysfunction-associated steatohepatitis.