The study details the connection between SCARB2 deficiency and gastrointestinal dysfunction, revealing that the loss of SCARB2 leads to alterations in bile acid metabolism and dysbiosis in the gut microbiome. This disruption affects the signaling pathway involving FXR, which normally regulates bile acid synthesis and intestinal lipid absorption. The hyperactive FXR in Scarb2-deficient mice leads to a decrease in epithelial cell turnover and lipid malabsorption, particularly impacting the absorption of vitamin E, which is crucial for maintaining neurological health. The researchers further explored the impact of these changes on the gut-liver axis and found alterations in the expression of genes related to bile acid synthesis.