AUTHOR=Qin Zizhen , Wu Wanning , Yang Xinyu , Wang Xiao , Ding Anni , Huang Yueyi , Tang Jiaxuan , Jiang Siyuan , Zhang Peng , Qian Chenwei , Zhang Xiangrui , Zhou Shihan , Wang Yanqing , Song Zhouchenghao , Sun Minjie , Wang Mingqiang , Shen Shuang , Zhu Boran 

TITLE=The role of trimethylamine N-oxide in disease pathogenesis and the therapeutic potential of traditional Chinese medicine

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1592524

DOI=10.3389/fphar.2025.1592524

ISSN=1663-9812

ABSTRACT=Trimethylamine N-oxide (TMAO), a metabolite derived from gut microbiota, has been implicated in the pathogenesis of various chronic diseases, including cardiovascular, digestive, neurological, and renal disorders. This review explores the complex mechanisms by which TMAO contributes to disease progression, including its role in inflammation, oxidative stress, and metabolic disorders. The study focused on the potential of traditional Chinese medicine (TCM) to regulate TMAO levels and mitigate its adverse effects. TCM interventions, through modulation of gut microbiota and inhibition of key enzymes like flavin-containing monooxygenase 3 (FMO3), offer promising therapeutic avenues. Despite the positive outcomes observed in preliminary studies, further research is needed to fully elucidate the mechanisms by which TCM interacts with TMAO and to establish its efficacy in clinical settings.