法尼醇 X 受体 (FXR) 是一种配体激活的转录因子，在调节肠肝循环内的胆汁酸代谢中发挥着至关重要的作用。除了影响各种组织的代谢紊乱和免疫失衡之外，FXR 还与微生物群调节、肠脑通讯和肝脏疾病有关。肝脏作为重要的代谢和解毒器官，很容易受到酒精、病毒、药物和高脂肪饮食等因素的损害。慢性或复发性肝损伤可最终导致肝纤维化，如果不及时治疗，可能会发展为肝硬化甚至肝癌，造成重大健康风险。然而，就 FDA 批准的药物而言，肝纤维化的治疗选择仍然有限。最近对 FXR 结构的深入了解，加上动物和临床研究，揭示了其在肝纤维化中的潜在药理作用。在基础研究和临床应用方面均取得了进展。这篇综述批判性地审视了 FXR 研究的最新进展，强调了其在肝纤维化治疗中的作用所面临的挑战和潜在机制。

The farnesoid X receptor (FXR), a ligand-activated transcription factor, plays a crucial role in regulating bile acid metabolism within the enterohepatic circulation. Beyond its involvement in metabolic disorders and immune imbalances affecting various tissues, FXR is implicated in microbiota modulation, gut- to-brain communication, and liver disease. The liver, as a pivotal metabolic and detoxification organ, is susceptible to damage from factors such as alcohol, viruses, drugs, and high-fat diets. Chronic or recurrent liver injury can culminate in liver fibrosis, which, if left untreated, may progress to cirrhosis and even liver cancer, posing significant health risks. However, therapeutic options for liver fibrosis remain limited in terms of FDA- approved drugs. Recent insights into the structure of FXR, coupled with animal and clinical investigations, have shed light on its potential pharmacological role in hepatic fibrosis. Progress has been achieved in both fundamental research and clinical applications. This review critically examines recent advancements in FXR research, highlighting challenges and potential mechanisms underlying its role in liver fibrosis treatment.