Trimethylamine-N-oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human body

Introduction This study reviews the different steps involved in trimethylamine-N-oxide (TMAO) formation, a gut microbiota (GM)-derived compound that promotes cardiovascular and chronic kidney disease. The formation of TMAO is a metaorganismal process, where trimethylamine (TMA), produced from the di...

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Main Authors: Ylenia Heinrich-Sanchez, Marius Vital
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2525403
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author Ylenia Heinrich-Sanchez
Marius Vital
author_facet Ylenia Heinrich-Sanchez
Marius Vital
author_sort Ylenia Heinrich-Sanchez
collection DOAJ
description Introduction This study reviews the different steps involved in trimethylamine-N-oxide (TMAO) formation, a gut microbiota (GM)-derived compound that promotes cardiovascular and chronic kidney disease. The formation of TMAO is a metaorganismal process, where trimethylamine (TMA), produced from the dietary precursors betaine, L-carnitine and choline by various members of GM, is absorbed and subsequently oxidized by hepatic flavin-containing monooxygenases before entering the circulation.Results and discussion We provide an updated database on members of GM exhibiting different biochemical pathways and give comprehensive insights into tested as well as hypothetical treatment options to reduce TMAO concentrations in the body. Different angles involving nutrition, TMA-producing bacteria, and their enzymes, as well as host enzymes, are discussed.Conclusion The study underlines the importance to design personalized therapies taking individual features, such as dietary habits and GM composition, into account. Given the multistep nature of TMAO formation, individualized precision multi-target strategies, for instance, reducing dietary precursors in combination with specific modulations of GM limiting growth/activity of TMA-producing bacteria, might be most successful.
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spelling doaj-art-56f3e0fadc6149e29fbdf2acae1dca982025-08-20T02:37:36ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2525403Trimethylamine-N-oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human bodyYlenia Heinrich-Sanchez0Marius Vital1Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, GermanyInstitute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, GermanyIntroduction This study reviews the different steps involved in trimethylamine-N-oxide (TMAO) formation, a gut microbiota (GM)-derived compound that promotes cardiovascular and chronic kidney disease. The formation of TMAO is a metaorganismal process, where trimethylamine (TMA), produced from the dietary precursors betaine, L-carnitine and choline by various members of GM, is absorbed and subsequently oxidized by hepatic flavin-containing monooxygenases before entering the circulation.Results and discussion We provide an updated database on members of GM exhibiting different biochemical pathways and give comprehensive insights into tested as well as hypothetical treatment options to reduce TMAO concentrations in the body. Different angles involving nutrition, TMA-producing bacteria, and their enzymes, as well as host enzymes, are discussed.Conclusion The study underlines the importance to design personalized therapies taking individual features, such as dietary habits and GM composition, into account. Given the multistep nature of TMAO formation, individualized precision multi-target strategies, for instance, reducing dietary precursors in combination with specific modulations of GM limiting growth/activity of TMA-producing bacteria, might be most successful.https://www.tandfonline.com/doi/10.1080/07853890.2025.2525403TrimethylamineTMAOcardiovascular diseasemicrobiotaintervention
spellingShingle Ylenia Heinrich-Sanchez
Marius Vital
Trimethylamine-N-oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human body
Annals of Medicine
Trimethylamine
TMAO
cardiovascular disease
microbiota
intervention
title Trimethylamine-N-oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human body
title_full Trimethylamine-N-oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human body
title_fullStr Trimethylamine-N-oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human body
title_full_unstemmed Trimethylamine-N-oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human body
title_short Trimethylamine-N-oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human body
title_sort trimethylamine n oxide formation the bacterial taxa involved and intervention strategies to reduce its concentration in the human body
topic Trimethylamine
TMAO
cardiovascular disease
microbiota
intervention
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2525403
work_keys_str_mv AT yleniaheinrichsanchez trimethylaminenoxideformationthebacterialtaxainvolvedandinterventionstrategiestoreduceitsconcentrationinthehumanbody
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