NR1H4 and metabolic dysfunction-associated steatohepatitis: By contrast, activation of the Farnesoid X receptor (FXR) in the liver, using various small molecule FXR agonists, has been mechanistically tied to development of an undesirable and potentially pro-atherogenic circulating lipid profile [26], despite beneficial FXR-mediated effects detected in livers of NASH patients during clinical trials [27].