New research paper suggests high TMAO levels associated with heart disease

The more of this by-product, called trimethylamine N-oxide or TMAO, a person or mouse has in the blood, the higher the risk of getting heart disease, the researchers found.

Gut bacteria are actually middlemen in TMAO production. The microbes convert lecithin to a gas that smells like rotten fish. Then an enzyme in the liver changes the foul-smelling gas to TMAO...

...The researchers don’t know exactly which types of gut bacteria make TMAO.

These findings show that the interactions of gut bacteria with diet can influence health, says Rader. The work also suggests that probiotics or drugs might be able to block TMAO production.

2011 Pubmed Abstract : Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease

A new research paper suggests that high trimethylamine oxide (TMAO) levels in the blood may be a predictor of heart disease. This is inadvertently of special interest to those with trimethylamninuria because the high TMAO levels will be a result of gut bacterial degradation of choline to trimethylamine (TMA) which is then oxidized by the liver to TMAO. So it may lead to more research into TMAO, particularly into which gut bacteria produce TMA since it currently seems not to be public knowledge as to which species of bacteria produce the TMA. It may also lead to TMAO being more commonly tested. With TMAU, TMAO is probably mostly an issue in secondary TMAU, because in these cases the TMA and TMAO levels are much higher than normal. The authors may not have researched if TMA can be a predictor of heart disease too, because it is not expected to be in high levels in most humans (being converted from TMA to TMAO). In the TMAU community this is unfortunately not the case.

At this stage we can only watch with interest to see how this new lead develops, but hopefully it may indirectly (or directly) lead to more interest and treatment of TMAU.

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Links:

Science News : Gut microbes producing trimethylamine oxide may foster heart disease

Eurekalert.org article on subject

Abstract in nature.com
Supplementary information in nature.com