Gut Microbiota-Dependent Marker TMAO in Promoting Cardiovascular Disease: Inflammation Mechanism, Clinical Prognostic, and Potential as a Therapeutic Target
- 1Guang’anmen Hospital, China Academy of Chinese Medical Sciences, China
- 2Xiyuan Hospital, China Academy of Chinese Medical Sciences, China
Cardiovascular disease (CVD) is the leading cause of death worldwide, especially in developed countries, and atherosclerosis (AS) is the common pathological basis of many cardiovascular diseases (CVDs) such as coronary heart disease (CHD). The role of the gut microbiota in AS has begun to be appreciated in recent years. Trimethylamine N-oxide (TMAO), an important gut microbe-dependent metabolite, is generated from dietary choline, betaine, and L-carnitine. Multiple studies have suggested a correlation between plasma TMAO levels and the risk of AS. However, the mechanism underlying this relationship is still unclear. In this review, we discuss the TMAO-involved mechanisms of atherosclerotic CVD from the perspective of inflammation, inflammation-related immunity, cholesterol metabolism, and atherothrombosis. We also summarize available clinical studies on the role of TMAO in predicting prognostic outcomes, including major adverse cardiovascular events (MACE), in patients presenting with AS. Finally, since TMAO may be a novel therapeutic target for AS, several therapeutic strategies including drugs, dietary, etc. to lower TMAO levels that are currently being explored are also discussed.
Keywords: Trimethylamine N-oxide, Atherosclerosis, cardiovascular disease, inflammation mechanism, clinical prognostic stratification, therapy
Received: 01 Aug 2019;
Accepted: 28 Oct 2019.
Copyright: © 2019 Yang, Li, Yang, Zhao, Pan, Liu, Xing and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Mx. Longtao Liu, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China, firstname.lastname@example.org
Mx. Yanwei Xing, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, Beijing Municipality, China, email@example.com
Mx. Min Wu, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, Beijing Municipality, China, firstname.lastname@example.org