Implication of Trimethylamine N-Oxide (TMAO) in disease: Potential biomarker or new therapeutic target

Trimethylamine N-oxide (TMAO) is a molecule generated from choline, betaine, and carnitine via gut microbial metabolism. The plasma level of TMAO is determined by several factors including diet, gut microbial flora, drug administration and liver flavin monooxygenase activity. In humans, recent clini...

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Authors: Janeiro-Arenas, M.H. (Manuel Humberto)|||/items/ac839365-86e1-4b60-9745-95f017428d7e, Ramírez-Gil, M.J. (María Javier)|||/items/2d48ae79-411f-45a1-bd65-bbee2aa118da, Milagro-Yoldi, F.I. (Fermín Ignacio)|||/items/07cf7af6-1f5f-4720-8c14-5197a7a724eb, Martinez, J.A. (José Alfredo)|||/items/6a3581ea-897b-4439-a95c-19301775e131, Solas-Zubiaurre, M. (Maite)|||/items/8cb01e14-a547-4965-8066-dfdacaec4544
Format: article
Publication Date:2018
Country:España
Institution:Universidad de Navarra
Repository:Dadun. Depósito Académico Digital de la Universidad de Navarra
Language:English
OAI Identifier:oai:dadun.unav.edu:10171/64613
Online Access:https://hdl.handle.net/10171/64613
Access Level:Open access
Keyword:Microbiota
Gut dysbiosis
Cardiovascular disease
Neurological disorder
Inflammation
Antibiotics
Description
Summary:Trimethylamine N-oxide (TMAO) is a molecule generated from choline, betaine, and carnitine via gut microbial metabolism. The plasma level of TMAO is determined by several factors including diet, gut microbial flora, drug administration and liver flavin monooxygenase activity. In humans, recent clinical studies evidence a positive correlation between elevated plasma levels of TMAO and an increased risk for major adverse cardiovascular events. A direct correlation between increased TMAO levels and neurological disorders has been also hypothesized. Several therapeutic strategies are being explored to reduce TMAO levels, including use of oral broad spectrum antibiotics, promoting the growth of bacteria that use TMAO as substrate and the development of target-specific molecules. Despite the accumulating evidence, it is questioned whether TMAO is the mediator of a bystander in the disease process. Thus, it is important to undertake studies to establish the role of TMAO in human health and disease. In this article, we reviewed dietary sources and metabolic pathways of TMAO, as well as screened the studies suggesting possible involvement of TMAO in the etiology of cardiovascular and neurological disorders, underlying the importance of TMAO mediating inflammatory processes. Finally, the potential utility of TMAO as therapeutic target is also analyzed.