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(2) produce H 2 S which could induce hepatic FXR and inhibit CYP7A1 expression and bile acid synthesis, (3) these collectively, modulate hepatic bile acid metabolism to produce more hydrophobic bile acids due to increased DCA and decreased MCA, which increases HI of bile acids facilitating intestinal cholesterol absorption (4) resulting in hepatic cholesterol overloading, and thereafter (5) promoting canalicular cholesterol secretion into bile and gallstone formation

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5 Gatto, A., Liu, K., Milan, N., & Wong, S