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TMAO and the gut microbiome: implications for the CVD-CKD-IBD axis.

Si Hyoung Kim1, Mi Young Yoon1,2,3, Sang Sun Yoon1,2,3

  • 1Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Korea.

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Trimethylamine N-oxide (TMAO), a gut microbe metabolite, is linked to cardiovascular, kidney, and inflammatory bowel diseases. Reducing TMAO via microbiome therapies may offer new treatment strategies for these chronic conditions.

Keywords:
Trimethylamine N-oxidecardiovascular diseasechronic kidney diseaseinflammatory bowel diseasemicrobiome

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Area of Science:

  • Microbiology
  • Metabolomics
  • Gastroenterology

Background:

  • Trimethylamine N-oxide (TMAO) is a gut microbial metabolite derived from dietary choline and carnitine.
  • Elevated TMAO levels are associated with cardiovascular disease (CVD), chronic kidney disease (CKD), and inflammatory bowel disease (IBD).
  • The precise role of TMAO in the pathogenesis of these inflammatory and fibrotic conditions is not fully understood.

Purpose of the Study:

  • To review the potential role of TMAO as a unifying factor in the IBD-CKD-CVD disease spectrum.
  • To highlight the significance of reducing TMAO production for managing chronic diseases.
  • To explore microbiome-targeted therapies as a strategy for TMAO reduction.

Main Methods:

  • Literature review of existing research on TMAO metabolism and its association with chronic diseases.
  • Analysis of the proposed mechanisms linking TMAO to inflammation, oxidative stress, and fibrosis.
  • Evaluation of current and emerging strategies for TMAO reduction, with a focus on microbiome interventions.

Main Results:

  • TMAO may act as a crucial link connecting IBD, CKD, and CVD.
  • Strategies aimed at limiting TMAO production are important for disease management.
  • Microbiome therapies present a promising, innovative approach to control TMAO levels.

Conclusions:

  • TMAO is implicated in a spectrum of chronic diseases including IBD, CKD, and CVD.
  • Targeting TMAO production, particularly through microbiome modulation, offers a potential therapeutic avenue.
  • Further research into microbiome therapies could lead to novel treatments for complex systemic diseases.