TMA/TMAO in Hypertension: Novel Horizons and Potential Therapies

J Cardiovasc Transl Res. 2021 Dec;14(6):1117-1124. doi: 10.1007/s12265-021-10115-x. Epub 2021 Mar 11.

Abstract

Hypertension is the most prevalent chronic disease and a risk factor for various diseases. Although its mechanisms and therapies are constantly being updated and developed, they are still not fully clarified. In recent years, novel gut microbiota and its metabolites have attracted widespread attention. It is strongly linked with physiological and pathological systems, especially TMA and TMAO. TMA is formed by intestinal microbial metabolism of choline and L-carnitine and converted into TMAO by FMO3. This paper collected and collated the latest researches and mainly discussed the following four parts. It introduced gut microbiota; provided a focus on TMA, TMA-producing bacteria, and TMAO; summarized the alternations in hypertensive patients and animals; discussed the mechanisms of TMAO with two respects; and summarized the regulatory factors may be as new interventions and therapies of hypertension. And, more relevant studies are still prospected to be accomplished between hypertension and TMA/TMAO for further clinical services.

Keywords: Gut microbiota; Hypertension; Inflammation; TMA; TMAO.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Carnitine / metabolism
  • Choline / metabolism
  • Gastrointestinal Microbiome / immunology
  • Gastrointestinal Microbiome / physiology*
  • Glucose / metabolism
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / metabolism*
  • Inflammation / metabolism
  • Lipid Metabolism
  • Methylamines / metabolism*

Substances

  • Methylamines
  • trimethyloxamine
  • Glucose
  • Choline
  • Carnitine