From bile to vessels: linking obesity to endothelial dysfunction

Taurochenodeoxycholic acid (TCDCA; the taurine-conjugated form of CDCA) alleviates obesity-induced endothelial dysfunction through farnesoid X receptor (FXR) activation and metabolic reprogramming. This TCDCA-FXR interaction restores nitric oxide bioavailability, reduces oxidative stress, and thereby alleviates endothelial dysfunction across human, murine, and cellular models. Remaining uncertainties include disease heterogeneity, its efficacy in old and multimorbid patients of both sexes, vascular-bed specific differences, and potential differences between CDCA and TCDCA.