4.7 Review

The gut microbial metabolite trimethylamine N-oxide and cardiovascular diseases

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Summary: Heart failure is a clinical syndrome in the late stage of cardiovascular disease, and research shows that the gut microbiota metabolite TMAO is associated with adverse outcomes in HF. Lowering TMAO levels may improve the prognosis of HF patients.
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Summary: The study demonstrates that TMAO increases the risk of cardiovascular events and affects platelets and vascular tissue factor TF. Experimental results indicate that TMAO enhances arterial thrombosis potential by inducing the expression of TF and VCAM1.

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Summary: The collection of normal microorganisms in our gut plays a significant role in our health, while dysbiosis in the gut microbial pool has been proven to be crucial in the pathophysiology of various diseases, including cardiovascular disease. In addition to traditional risk factors, research has also highlighted the involvement of gut bacteria and their metabolites in the pathogenesis of CVD.

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Gut-Flora-Dependent Metabolite Trimethylamine-N-Oxide Promotes Atherosclerosis-Associated Inflammation Responses by Indirect ROS Stimulation and Signaling Involving AMPK and SIRT1

Sa Zhou et al.

Summary: This study revealed the mechanistic link between TMAO and atherosclerosis risk, showing that TMAO induces vascular inflammation. It was found that TMAO suppresses the expression of AMPK and SIRT1, while AMPK and SIRT1 play important roles in regulating ROS and inflammation. Glutathione and probiotics can relieve TMAO-induced atherosclerosis.

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Gut Microbiota-Derived Metabolites and Cardiovascular Disease Risk: A Systematic Review of Prospective Cohort Studies

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Summary: The gut microbiome has recently been found to be associated with heart failure (HF), a global health issue characterized by cardiac dysfunction. Although the underlying mechanism is still unclear, studies have suggested that microbial metabolites influenced by dietary factors may affect the development of HF. This review focuses on the advances and potential therapeutic targets in HF related to trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), and bile acids (BAs), as well as the potential application of microbial metabolites in HF therapy.

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Trimethylamine N-oxide and its precursors in relation to blood pressure: A mendelian randomization study

Han Wang et al.

Summary: This study utilized Mendelian Randomization to reveal a causal relationship between TMAO and its precursors with blood pressure, suggesting that mediating the generation of TMAO may be beneficial for lowering blood pressure.

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Summary: This study used Mendelian randomization analysis to reveal the causal effect of gut microbiota and metabolites on heart failure and its risk factors. The results showed that candida and campylobacter were not associated with higher incidence of heart failure, while increasing concentration of shigella was associated with higher risks of myocarditis and hypertrophic cardiomyopathy. In addition, increased concentration of candida was associated with higher risk of chronic kidney disease, and betaine was associated with higher risks of heart failure and myocardial infarction.

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Summary: Cardiovascular diseases, particularly atherosclerotic cardiovascular diseases, are a major global burden. Emerging research on gut microbiota has revealed the significant role of trimethylamine oxide (TMAO), a metabolite from gut microbes, in atherosclerosis. Targeting TMAO may offer potential therapeutic strategies for atherosclerosis.

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Asim K. Duttaroy

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Renata A. G. Reis et al.

Summary: Flavin-dependent monooxygenases play important roles in biological processes, with recent research focusing on formation of reactive intermediates and catalytic mechanisms. Novel catalysis by different N-oxidases and their relevance to organisms are discussed. Additionally, some FMOs are crucial for the virulence of human pathogens and have biomedical importance in antibiotic resistance.

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Trimethylamine N-Oxide (TMAO), Diet and Cardiovascular Disease

Minu S. Thomas et al.

Summary: The link between plasma TMAO levels and CVD risk is established in epidemiological research, but the role of dietary precursors in determining TMAO levels is still inconclusive. Recent studies show positive associations between plasma TMAO concentrations and various CVD risk factors, but the impact of dietary choline and carnitine on chronic plasma TMAO levels and CVD risk requires further investigation.

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Can diet modulate trimethylamine N-oxide (TMAO) production? What do we know so far?

Karen Salve Coutinho-Wolino et al.

Summary: Nutrients and bioactive compounds in food can reduce the production of harmful metabolite TMAO by modulating the gut microbiota and influencing specific enzymes in the liver. However, further clinical studies are needed to evaluate the effectiveness, dosage, and timing of intervention of these dietary components on TMAO levels.

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Dietary phosphatidylcholine supplementation reduces atherosclerosis in Ldlr-/- male mice2

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Summary: Choline is an essential nutrient that plays a role in various biological processes, and the form of dietary choline intake can influence the development of atherosclerosis. Increased intake of phosphatidylcholine in the diet may reduce the risk of atherosclerosis but is associated with higher plasma TMAO levels.

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Donglin Du et al.

Summary: The study demonstrates that traumatic brain injury alters gut microbiota, while fecal microbiota transplantation can restore dysbiosis and alleviate neurological deficits possibly through the TMA-TMAO-MsrA signaling pathway.

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Plasma trimethylamine N-oxide and its metabolic precursors and risk of mortality, cardiovascular and renal disease in individuals with type 2-diabetes and albuminuria

Signe Abitz Winther et al.

Summary: In individuals with type 2 diabetes and albuminuria, higher levels of choline, carnitine, and a combined score of the four metabolites in the TMAO pathway were associated with an increased risk of renal function decline, but not with all-cause mortality or cardiovascular disease.

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Summary: Hypertension, as the most prevalent chronic disease and risk factor for various diseases, has been linked with novel gut microbiota and its metabolites, suggesting potential new interventions for treatment. Further research is needed to explore the relationship between hypertension and TMA/TMAO for clinical applications.

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Trimethylamine/Trimethylamine-N-Oxide as a Key Between Diet and Cardiovascular Diseases

Siyu He et al.

Summary: TMA and TMAO, derived from gut microbiota, may be potential risk factors for cardiovascular diseases, with controversial roles and potential involvement of TMA in disease progression. Further exploration of the relationship between TMA, TMAO, and CVD could provide novel insights for diagnosis and therapy.

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Temporal Course of Plasma Trimethylamine N-Oxide (TMAO) Levels in ST-Elevation Myocardial Infarction

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Trimethylamine-N-oxide-stimulated hepatocyte-derived exosomes promote inflammation and endothelial dysfunction through nuclear factor-kappa B signaling

Xiang Liu et al.

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High-fat diet-induced colonocyte dysfunction escalates microbiota-derived trimethylamine N-oxide

Woongjae Yoo et al.

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Higher Trimethylamine-N-Oxide Plasma Levels with Increasing Age Are Mediated by Diet and Trimethylamine-Forming Bacteria

Silke Rath et al.

Summary: The gut microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) is associated with an increased risk for cardiovascular diseases. While meat intake did not directly predict TMAO plasma levels, it was linked to TMA-forming bacteria. Additionally, advancing age was strongly associated with TMAO levels, demonstrating a functional role of gut microbiota in the aging process.

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Trimethylamine N-Oxide is Associated with Heart Failure Risk in Patients with Preserved Ejection Fraction

Zengxiang Dong et al.

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Review Immunology

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CANADIAN JOURNAL OF CARDIOLOGY (2014)

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ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA (2014)

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PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA (2014)

Article Biochemistry & Molecular Biology

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NATURE MEDICINE (2013)

Article Medicine, General & Internal

Intestinal Microbial Metabolism of Phosphatidylcholine and Cardiovascular Risk

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NEW ENGLAND JOURNAL OF MEDICINE (2013)

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NATURE (2012)

Review Gastroenterology & Hepatology

The bile salt export pump (BSEP) in health and disease

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CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY (2012)

Article Multidisciplinary Sciences

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NATURE (2011)

Review Microbiology

Unravelling the effects of the environment and host genotype on the gut microbiome

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Article Multidisciplinary Sciences

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NATURE (2010)

Article Biochemistry & Molecular Biology

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