{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:02:40Z","timestamp":1781071360641,"version":"3.54.1"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"\n Background<\/jats:title>\n Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease. Increasing evidence suggests that gut microbiota dysbiosis may contribute to its pathogenesis and progression. However, existing studies are limited by small sample sizes, methodological inconsistency, and the lack of quantitative synthesis, resulting in insufficient consolidated evidence.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This systematic review and meta-analysis aimed to evaluate alterations in the gut microbiota of patients with PBC.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n PubMed, Web of Science, Embase, and the Cochrane Library were systematically searched from inception to January 23, 2026. Outcomes included alpha-diversity indices, beta diversity, and taxonomic alterations. Meta-analyses were performed using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Sensitivity analysis, subgroup analysis, and meta-regression were conducted to explore potential sources of heterogeneity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1,326 records screened, 10 studies involving 1,057 participants (607 patients with PBC and 450 controls) were included, and all studies had Newcastle\u2013Ottawa Scale scores of at least 7. Compared with controls, patients with PBC had a significantly lower Shannon index (SMD\u202f=\u202f\u22120.72, 95% CI: \u22121.22 to \u22120.22,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001; I\n 2<\/jats:sup>\n \u202f=\u202f91.0%) and fewer operational taxonomic units (OTUs) (SMD\u202f=\u202f\u22120.57, 95% CI: \u22120.81 to \u22120.33,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001; I\n 2<\/jats:sup>\n \u202f=\u202f45.4%), whereas the Simpson index was significantly higher (SMD\u202f=\u202f0.81, 95% CI: 0.40 to 1.21,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001; I\n 2<\/jats:sup>\n \u202f=\u202f44.4%). After exclusion of an outlier study, the Chao1 index was also significantly reduced (SMD\u202f=\u202f\u22120.38, 95% CI: \u22120.63 to \u22120.15, p\u202f&lt;\u202f0.001; I\n 2<\/jats:sup>\n \u202f=\u202f22.6%), while no significant difference was observed for the ACE index. Most studies also reported significant differences in beta diversity between patients with PBC and healthy controls. Taxonomic analysis showed enrichment of\n Neisseria<\/jats:italic>\n ,\n Klebsiella<\/jats:italic>\n ,\n Veillonella<\/jats:italic>\n ,\n Bifidobacterium<\/jats:italic>\n ,\n Lactobacillus<\/jats:italic>\n ,\n Streptococcus<\/jats:italic>\n ,\n Enterococcus<\/jats:italic>\n ,\n Clostridium<\/jats:italic>\n , and\n Escherichia<\/jats:italic>\n , whereas\n Bacteroides<\/jats:italic>\n ,\n Faecalibacterium<\/jats:italic>\n ,\n Blautia<\/jats:italic>\n ,\n Roseburia<\/jats:italic>\n ,\n Coprococcus<\/jats:italic>\n ,\n Oscillospira<\/jats:italic>\n , and\n Morganella<\/jats:italic>\n were generally depleted in PBC. Meta-regression did not identify age, geographic region, or sequencing platform as significant sources of heterogeneity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n PBC is associated with gut microbiota alterations, characterized by reduced alpha diversity, altered community structure, and taxonomic remodeling. Longitudinal and functional studies are needed to clarify causality, mechanisms, and clinical applications.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1847865","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:20:53Z","timestamp":1781068853000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gut microbiota alterations in primary biliary cholangitis: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Ren","family":"Qianlang","sequence":"first","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao","family":"Yanxin","sequence":"additional","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Dejia","sequence":"additional","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Guoqing","sequence":"additional","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Lihong","sequence":"additional","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Hang","sequence":"additional","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Xianmei","sequence":"additional","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lv","family":"Junyan","sequence":"additional","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma","family":"Lanqing","sequence":"additional","affiliation":[{"name":"Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref1","year":"2025"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2701","DOI":"10.1177\/09622802211047348","article-title":"Estimating the sample mean and standard deviation from order statistics and sample size in meta-analysis","volume":"30","author":"Cai","year":"2021","journal-title":"Stat. Methods Med. Res."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"8480","DOI":"10.1097\/js9.0000000000002977","article-title":"A meta-analysis of changes in gut microbiota structure following bariatric surgery","volume":"111","author":"Chen","year":"2025","journal-title":"Int. J. Surg."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"264","DOI":"10.3760\/cma.j.cn112138-20211112-00794-1","article-title":"Guidelines on the diagnosis and management of primary biliary cholangitis (2021)","volume":"30","year":"2022","journal-title":"Zhonghua Gan Zang Bing Za Zhi"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2420765","DOI":"10.1080\/19490976.2024.2420765","article-title":"How important are fatty acids in human health and can they be used in treating diseases?","volume":"16","author":"Dicks","year":"2024","journal-title":"Gut Microbes"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"228","DOI":"10.14000\/j.cnki.issn.1008-1704.2022.02.014","article-title":"Correlation between intestinal microbiota abundance and diversity and short-term response to ursodeoxycholic acid in patients with primary biliary cholangitis","volume":"27","author":"Ding","year":"2022","journal-title":"Liver"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"410","DOI":"10.2353\/ajpath.2006.050404","article-title":"Lithocholic acid feeding induces segmental bile duct obstruction and destructive cholangitis in mice","volume":"168","author":"Fickert","year":"2006","journal-title":"Am. J. Pathol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1111\/hepr.13509","article-title":"Gut dysbiosis associated with clinical prognosis of patients with primary biliary cholangitis","volume":"50","author":"Furukawa","year":"2020","journal-title":"Hepatol. Res."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e1001377","DOI":"10.1371\/journal.pbio.1001377","article-title":"The human microbiome project: a community resource for the healthy human microbiome","volume":"10","author":"Gevers","year":"2012","journal-title":"PLoS Biol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4321","DOI":"10.3390\/ijms25084321","article-title":"Exploring advanced therapies for primary biliary cholangitis: insights from the gut microbiota\u2013bile acid\u2013immunity network","volume":"25","author":"Guo","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e0229204","DOI":"10.1371\/journal.pone.0229204","article-title":"An empirically derived method for measuring human gut microbiome alpha diversity: demonstrated utility in predicting health-related outcomes among a human clinical sample","volume":"15","author":"Hagerty","year":"2020","journal-title":"PLoS One"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s13578-024-01253-1","article-title":"Distinct signatures of gut microbiota and metabolites in primary biliary cholangitis with poor biochemical response after ursodeoxycholic acid treatment","volume":"14","author":"Han","year":"2024","journal-title":"Cell Biosci."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1038\/s41586-019-1785-z","article-title":"Bile acid metabolites control T(H)17 and T(reg) cell differentiation","volume":"576","author":"Hang","year":"2019","journal-title":"Nature"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.clim.2008.01.010","article-title":"A possible role of histone-like DNA-binding protein of Streptococcus intermedius in the pathogenesis of bile duct damage in primary biliary cirrhosis","volume":"127","author":"Haruta","year":"2008","journal-title":"Clin. Immunol."},{"key":"ref15","doi-asserted-by":"crossref","DOI":"10.1002\/9781119536604","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins","year":"2019"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"239","DOI":"10.3390\/life14020239","article-title":"The impact of probiotic Bifidobacterium on liver diseases and the microbiota","volume":"14","author":"Hizo","year":"2024","journal-title":"Life"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/j.molimm.2013.10.004","article-title":"Lipoteichoic acid of Streptococcus mutans interacts with toll-like receptor 2 through the lipid moiety for induction of inflammatory mediators in murine macrophages","volume":"57","author":"Hong","year":"2014","journal-title":"Mol. Immunol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s41232-023-00315-0","article-title":"The gut-liver axis in hepatobiliary diseases","volume":"44","author":"Ichikawa","year":"2024","journal-title":"Inflamm Regen"},{"key":"ref19","first-page":"470","article-title":"Bias in meta-analysis detected by a simple, graphical test. Graphical test is itself biased","volume":"316","author":"Irwig","year":"1998","journal-title":"BMJ"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2383353","DOI":"10.1080\/19490976.2024.2383353","article-title":"The fecal microbiota of patients with primary biliary cholangitis (PBC) causes PBC-like liver lesions in mice and exacerbates liver damage in a mouse model of PBC","volume":"16","author":"Jiang","year":"2024","journal-title":"Gut Microbes"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"359A","DOI":"10.1002\/hep.32188","article-title":"Ileal mucosa-associated microbiota overgrowth in primary biliary cholangitis","volume":"74","author":"Kitahata","year":"2021","journal-title":"Hepatology"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1701101","DOI":"10.3389\/fmicb.2025.1701101","article-title":"Analyzing the gut liver axis: a dual role of the microbiome in the genesis, progression, and treatment of liver cell carcinoma","volume":"16","author":"Li","year":"2025","journal-title":"Front. Microbiol."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.4014\/jmb.2007.07046","article-title":"Antimicrobial and immunomodulatory effects of Bifidobacterium strains: a review","volume":"30","author":"Lim","year":"2020","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"100504","DOI":"10.1016\/j.medj.2024.08.003","article-title":"Gut microbiome pattern impacts treatment response in primary biliary cholangitis","volume":"6","author":"Liu","year":"2025","journal-title":"MED"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"101014","DOI":"10.3748\/wjg.v31.i10.101014","article-title":"Lactococcus garvieae aggravates cholestatic liver disease by increasing intestinal permeability and enhancing bile acid reabsorption","volume":"31","author":"Liu","year":"2025","journal-title":"World J. Gastroenterol."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"6974","DOI":"10.4049\/jimmunol.1000953","article-title":"Phosphoryl moieties of lipid a from Neisseria meningitidis and N. gonorrhoeae lipooligosaccharides play an important role in activation of both MyD88- and TRIF-dependent TLR4-MD-2 signaling pathways","volume":"185","author":"Liu","year":"2010","journal-title":"J. Immunol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1177\/0962280216669183","article-title":"Optimally estimating the sample mean from the sample size, median, mid-range, and\/or mid-quartile range","volume":"27","author":"Luo","year":"2018","journal-title":"Stat. Methods Med. Res."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2272","DOI":"10.1111\/1462-2920.13401","article-title":"Alterations and correlations of the gut microbiome, metabolism and immunity in patients with primary biliary cirrhosis","volume":"18","author":"Lv","year":"2016","journal-title":"Environ. Microbiol."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.autrev.2014.10.013","article-title":"The intestinal microbiota and microenvironment in liver","volume":"14","author":"Ma","year":"2015","journal-title":"Autoimmun. Rev."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"2208501","DOI":"10.1080\/19490976.2023.2208501","article-title":"Bacterial and metabolic phenotypes associated with inadequate response to ursodeoxycholic acid treatment in primary biliary cholangitis","volume":"15","author":"Martinez-Gili","year":"2023","journal-title":"Gut Microbes"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2520","DOI":"10.1177\/0962280219889080","article-title":"Estimating the sample mean and standard deviation from commonly reported quantiles in meta-analysis","volume":"29","author":"McGrath","year":"2020","journal-title":"Stat. Methods Med. Res."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2439","DOI":"10.1007\/s10620-020-06498-7","article-title":"Incidence of hepatocellular carcinoma in primary biliary cholangitis: a systematic review and Meta-analysis","volume":"66","author":"Natarajan","year":"2021","journal-title":"Dig. Dis. Sci."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"000","DOI":"10.14218\/jcth.2025.00212","article-title":"Gut microbiota: implications in pathogenesis and potential therapeutic target in primary biliary cholangitis","author":"Nie","year":"2025","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1038\/s41420-023-01404-2","article-title":"Butyrate potentiates Enterococcus faecalis lipoteichoic acid-induced inflammasome activation via histone deacetylase inhibition","volume":"9","author":"Park","year":"2023","journal-title":"Cell Death Discov."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"3294","DOI":"10.1038\/s41467-018-05470-4","article-title":"Microbial tryptophan catabolites in health and disease","volume":"9","author":"Roager","year":"2018","journal-title":"Nat. Commun."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1097\/hep.0000000000001225","article-title":"The immunological landscape of primary biliary cholangitis: mechanisms and therapeutic prospects","volume":"82","author":"Ronca","year":"2025","journal-title":"Hepatology"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1097\/HEP.0000000000000506","article-title":"Role of microbiome in autoimmune liver diseases","volume":"80","author":"Schneider","year":"2024","journal-title":"Hepatology"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur. J. Epidemiol."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/j.cgh.2025.03.025","article-title":"Global epidemiology of primary biliary cholangitis: an updated systematic review and Meta-analysis","volume":"24","author":"Tan","year":"2026","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1001\/jama.2025.20067","article-title":"Primary biliary cholangitis","volume":"335","author":"Tana","year":"2026","journal-title":"JAMA"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1111\/cei.13198","article-title":"Pathogen infections and primary biliary cholangitis","volume":"195","author":"Tanaka","year":"2019","journal-title":"Clin. Exp. Immunol."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1016\/s0140-6736(24)01303-5","article-title":"Primary biliary cholangitis","volume":"404","author":"Tanaka","year":"2024","journal-title":"Lancet"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1136\/gutjnl-2016-313332","article-title":"Gut microbial profile is altered in primary biliary cholangitis and partially restored after UDCA therapy","volume":"67","author":"Tang","year":"2018","journal-title":"Gut"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s13099-025-00753-w","article-title":"Progress and prospects of gut microbiota-targeted therapy for primary biliary cholangitis","volume":"17","author":"Tang","year":"2025","journal-title":"Gut Pathog"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1588129","DOI":"10.3389\/fimmu.2025.1588129","article-title":"The balance between proinflammatory, \"bad\", and immunomodulatory, \"good\", lipopolysaccharide for understanding gut-derived systemic inflammation","volume":"16","author":"Tume","year":"2025","journal-title":"Front. Immunol."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med. Res. Methodol."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"2566305","DOI":"10.1080\/19490976.2025.2566305","article-title":"The impact of very-low-calorie ketogenic diets on gut microbiota in individuals with obesity: a systematic review and meta-analysis","volume":"17","author":"Wang","year":"2025","journal-title":"Gut Microbes"},{"key":"ref49","first-page":"139","article-title":"Changes in intestinal microbiota in patients with primary biliary cholangitis detected by 16S rDNA sequencing","volume":"59","author":"Wang","year":"2021","journal-title":"Chinese J Modern Doctors"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"3917","DOI":"10.1007\/s00018-019-03190-6","article-title":"Bridging intestinal immunity and gut microbiota by metabolites","volume":"76","author":"Wang","year":"2019","journal-title":"Cell. Mol. Life Sci."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1053\/j.gastro.2024.05.014","article-title":"Gut microbiota-derived butyrate induces epigenetic and metabolic reprogramming in myeloid-derived suppressor cells to alleviate primary biliary cholangitis","volume":"167","author":"Wang","year":"2024","journal-title":"Gastroenterology"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"105368","DOI":"10.1016\/j.micinf.2024.105368","article-title":"Machine learning-based characterization of the gut microbiome associated with the progression of primary biliary cholangitis to cirrhosis","volume":"26","author":"Wang","year":"2024","journal-title":"Microbes Infect."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"e70165","DOI":"10.1002\/jgh3.70165","article-title":"Systematic review and Meta-analysis of the effects of intestinal microbiota on liver disease using mendelian randomization","volume":"9","author":"Xu","year":"2025","journal-title":"JGH Open"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"2668","DOI":"10.3390\/microorganisms13122668","article-title":"Decoding the gut microbiome in primary Sjogren's syndrome and primary biliary cholangitis: shared dysbiosis, distinct patterns, and associations with clinical features","volume":"13","author":"Zang","year":"2025","journal-title":"Microorganisms"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"000","DOI":"10.14218\/jcth.2022.00408","article-title":"Targeting gut microbiota for the treatment of primary biliary cholangitis: from bench to bedside","author":"Zhang","year":"2023","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"152565","DOI":"10.1016\/j.bbrc.2025.152565","article-title":"Clostridial-dominated gut microbiota promotes 7\u03b1-dehydroxylation of obeticholic acid to lithocholic acid in cholestasis treatment","volume":"782","author":"Zhang","year":"2025","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.12449\/jch250706","article-title":"Primary biliary cholangitis and intestinal microbiota","volume":"41","author":"Zhao","year":"2025","journal-title":"J Clin Hepatol"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"28301","DOI":"10.1038\/s41598-024-79227-z","article-title":"Bidirectional mendelian randomization links gut microbiota to primary biliary cholangitis","volume":"14","author":"Zhou","year":"2024","journal-title":"Sci. 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