Mechanisms and Intervention Strategies of Trimethylamine N-Oxide in Abdominal Aortic Aneurysm

Background: Abdominal aortic aneurysm (AAA) is a serious cardiovascular disease with high morbidity and mortality. The role of gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) in AAA pathogenesis has attracted increasing attention. Summary: This review systematically summarizes the mechanisms by which TMAO promotes AAA development, including inflammatory activation, apoptosis induction, and extracellular matrix degradation. TMAO interacts with risk factors such as atherosclerosis and hypertension through pathways involving NF-κB, NLRP3 inflammasome, and endoplasmic reticulum stress. Intervention strategies targeting dietary precursors, gut microbiota, and key enzymes are critically evaluated. Key Messages: TMAO serves as both a biomarker and a therapeutic target for AAA. Future research should prioritize personalized dietary interventions and novel TMAO inhibitors to bridge translational gaps.