Mechanisms and intervention strategies of TMAO (Trimethylamine NOxide) in abdominal aortic aneurysm

This review comprehensively discusses the role of trimethylamine oxide (TMAO) in abdominal aortic aneurysm (AAA). TMAO, a metabolite produced by gut microbiota acting on dietary precursors, is associated with various cardiovascular diseases. In AAA, TMAO is involved in multiple processes. It induces inflammation by promoting macrophage polarization and increasing inflammatory markers in vascular smooth muscle cells. It also participates in apoptosis and extracellular matrix remodeling. TMAO is closely associated with risk factors such as atherosclerosis, hypertension, and diabetes and affects their progression through multiple mechanisms, such as in atherosclerosis, where it promotes foam cell formation and endothelial cell damage. Intervention strategies for TMAO include dietary modification, gut microbiota regulation, and inhibition of key enzymes. Dietary modifications such as the Mediterranean diet can reduce TMAO levels, and probiotics and prebiotics have shown a potential to modulate gut microbiota to affect TMAO synthesis. However, these strategies have limitations and require further study. This review provides a comprehensive understanding of the role of TMAO in AAA and provides insights for future research and clinical applications.