Oxysterols in bile acid metabolism

► The role of oxysterols in bile acid metabolism has been reviewed in both physiologic and pathological conditions. ► Oxysterols regulate cholesterol synthesis and efflux, and bile acid synthesis by the classic and alternative pathways. ► Both the classic and alternative pathways of bile acid synthesis become mature after the age of 4 years. ► In patients with liver disease the classic pathway of bile acid synthesis is impaired while the alternative one is preserved. ► In case of obesity the alternative pathway of bile acid synthesis is increased possibly to counteract atherosclerosis risk.