Newly Identified Mechanisms of Total Parenteral Nutrition Related Liver Injury

<table>Schematic representation. (1) Bile acids (BA) secreted into bile. (2) BA reach terminal ileum. (3) BA cause secretion of FGF19 upon FXR stimulation. (4) FGF19 travels through the portal circulation to liver, binding to its receptor FGFR4. (5) Hepatic effects include suppression of CYP7A1, improvement in lipid profile, and glycemic control. FGFR4: fibroblast growth factor receptor 4; CYP7A1: cholesterol 7 alpha hydroxylase; FXR: farnesoid X receptor; FGF19: fibroblast growth factor 19.</table>

Advances in Hepatology

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Figure 1

Figure 1: Newly Identified Mechanisms of Total Parenteral Nutrition Related Liver Injury 