Trimethylamine-N-Oxide (TMAO): Potential Benefits, and Therapeutic Targets Conceivable as a Mitigation Strategy for Cardio-Metabolic Diseases


Oscar Mbembela*, Tuntufyege Mwasanjobe, Anselmo M Manisha, Suzan Kilamile, Hamad S Ali, Jacktan Josephat Ruhighira and Frederick Mashili

Trimethylamine-N-oxide (TMAO) is the gut microbiome derived metabolite synthesized from a volatile amine-containing organic compound called Trimethylamine (TMA) by the action of the hepatic Flavin Monooxygenase enzyme (FMO) isoform 1 and 3. TMA is largely synthesized from choline, betaine and L-carnitine by gut microbial enzymes. TMAO has been speculated to be independently associated with various cardiometabolic and chronic diseases in humans such as atherosclerosis, type 2 diabetes mellitus, cancers, Chronic Kidney Disease (CKD), heart failure and dyslipidemia. In marine animals, TMAO has been purported to be useful in counteracting the effect of osmotic stress and hydrostatic pressure emanating from their surrounding environment. In this review, the potential benefits and comparable deleterious effect of TMAO in animals and human has been elucidated. The interventions targeting TMAO in mitigating diseases have also been reviewed and concluded that based on the current stance of available literature on the effect of TMAO, the development of a validated non-lethal antagonist would confer protection and extend the life of patients with cardiometabolic and other chronic diseases.

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