Intestinal Flora Metabolite Trimethylamine Oxide Is Inextricably Linked to Coronary Heart Disease

Area of Science:

• Cardiovascular Research
• Microbiome Metabolism
• Biomarker Discovery

Background:

• Atherosclerotic coronary heart disease (CHD) presents significant global health challenges with increasing incidence in younger populations.
• Intestinal flora metabolites, particularly trimethylamine N-oxide (TMAO), are increasingly recognized as potential biomarkers for cardiovascular risk.
• While associations between TMAO and CHD are established, its precise pathogenic mechanisms remain incompletely elucidated.

Approach:

• This review synthesizes current research on the generation pathways of TMAO from dietary precursors.
• It critically examines the molecular mechanisms by which TMAO contributes to the development and progression of atherosclerotic coronary heart disease.
• The review also explores therapeutic strategies targeting TMAO production or action for managing CHD.

Key Points:

• TMAO is generated from dietary sources via gut microbiota metabolism.
• Elevated plasma TMAO levels are predictive of increased cardiovascular risk.
• TMAO's pro-atherogenic mechanisms involve inflammation, endothelial dysfunction, and lipid metabolism alterations.

Conclusions:

• Understanding TMAO generation and its role in CHD pathogenesis is crucial for developing novel therapeutic interventions.
• Targeting the gut microbiome or TMAO production offers promising avenues for preventing and treating coronary heart disease.
• Further research is warranted to fully elucidate TMAO's complex role and optimize treatment strategies.