The roles of trimethylamine-N-oxide in atherosclerosis and its potential therapeutic aspect: A literature review

Authors

  • Yudi Her Oktaviono Department of Cardiology and Vascular Medicine, General Hospital Dr. Soetomo, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
  • Ariikah Dyah Lamara Department of Cardiology and Vascular Medicine, General Hospital Dr. Soetomo, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
  • Pandit Bagus Tri Saputra Department of Cardiology and Vascular Medicine, General Hospital Dr. Soetomo, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia https://orcid.org/0000-0002-5815-0592
  • Jannatin Nisa Arnindita Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
  • Diar Pasahari Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia https://orcid.org/0000-0001-6785-8245
  • Mahendra Eko Saputra Department of Cardiology and Vascular Medicine, General Hospital Dr. Soetomo, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia https://orcid.org/0000-0002-4523-7592
  • Ni Made Adnya Suasti Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom

DOI:

https://doi.org/10.17305/bb.2023.8893

Keywords:

Atherosclerosis, gut microbiome, trimethylamine-N-oxide, coronary artery disease, cardiovascular risk

Abstract

Current research supports the evidence that the gut microbiome (GM), which consist of gut microbiota and their biologically active metabolites, is associated with atherosclerosis development. Trimethylamine-N-oxide (TMAO), a metabolite produced by the GM through trimethylamine (TMA) oxidation, significantly enhances the formation and vulnerability of atherosclerotic plaques. TMAO promotes inflammation and oxidative stress in endothelial cells, leading to vascular dysfunction and plaque formation. Dimethyl-1-butanol (DMB), iodomethylcholine (IMC) and fluoromethylcholine (FMC) have been recognized for their ability to reduce plasma TMAO by inhibiting trimethylamine lyase, a bacterial enzyme involved in the choline cleavage anaerobic process, thus reducing TMA formation. Conversely, indole-3-carbinol (I3C) and trigonelline inhibit TMA oxidation by inhibiting flavin-containing monooxygenase-3 (FMO3), resulting in reduced plasma TMAO. The combined use of inhibitors of choline trimethylamine lyase and flavin-containing monooxygenase-3 could provide novel therapeutic strategies for cardiovascular disease prevention by stabilizing existing atherosclerotic plaques. This review aims to present the current evidence of the roles of TMA/TMAO in atherosclerosis as well as its potential therapeutic prevention aspects.

Author Biographies

  • Yudi Her Oktaviono, Department of Cardiology and Vascular Medicine, General Hospital Dr. Soetomo, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia

     

     

  • Ariikah Dyah Lamara, Department of Cardiology and Vascular Medicine, General Hospital Dr. Soetomo, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia

     

     

  • Pandit Bagus Tri Saputra, Department of Cardiology and Vascular Medicine, General Hospital Dr. Soetomo, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia

     

     

  • Jannatin Nisa Arnindita, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia

     

     

  • Diar Pasahari, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia

     

     

  • Mahendra Eko Saputra, Department of Cardiology and Vascular Medicine, General Hospital Dr. Soetomo, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia

     

     

     

The roles of trimethylamine-N-oxide in atherosclerosis and its potential therapeutic aspect: A literature review

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Published

03-11-2023

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Reviews

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How to Cite

1.
The roles of trimethylamine-N-oxide in atherosclerosis and its potential therapeutic aspect: A literature review. Biomol Biomed [Internet]. 2023 Nov. 3 [cited 2024 Feb. 21];23(6):936–948. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/8893