Potential Roles of Flavonoids from Chrysanthemi Flos and Chrysanthemi Indici Flos in Modulating Bile Acid Metabolism: Mechanistic Insights and Future Perspectives

Changes in bile acid metabolism are associated with metabolic liver disease, inflammation, and immune dysfunction. Therefore, regulating bile acid homeostasis may help in preventing and treating liver injury and metabolic disorders. Chrysanthemi Flos and Chrysanthemi Indici Flos contain many bioactive flavonoids and have several reported pharmacological effects. However, how their flavonoids regulate bile acid metabolism has not been reviewed in detail. This review summarizes 52 flavonoids identified in Chrysanthemi Flos and Chrysanthemi Indici Flos. We review their reported effects on bile acid conjugation and synthesis, secretion and excretion, enterohepatic circulation, and main receptors, including FXR (farnesoid X receptor, nuclear bile acid receptor; regulates synthesis/transport), TGR5 (Takeda G protein-coupled receptor 5, GPCR (G protein-coupled receptor) bile acid receptor; GLP-1 (glucagon-like peptide-1) secretion, energy/anti-inflammation, incretin; glucose/lipid homeostasis), and LXRα (liver X receptor α, nuclear receptor; cholesterol efflux and CYP7A1 (cholesterol 7α-hydroxylase, rate-limiting enzyme of classical bile acid synthesis; cholesterol → 7α-hydroxycholesterol) regulation). We also consider how these pathways may affect inflammation and metabolic disorders. This review relates the reported mechanisms to the traditional use of these medicinal plants for “clearing the liver and promoting bile flow.” It also outlines research needs for assessing natural hepatoprotective and metabolic disease interventions that target bile acid metabolism.