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Advanced Neurology

REVIEW ARTICLE
Trimethylamine N-oxide: A new target for the

prevention and treatment of ischemic stroke

1
3
Qi-Yang Yuan , Yao-Wu Liu , Bao-Xin Wu , Shuo Li , Jin-Jin Yang , Fen Fang Gao ,
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1
1
1
1,2
Yu-Kun Wang , Chu Zhou , Shi-Guang Zhu *, and De-Qin Geng *
1,2
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1 Department of Neurology, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
2 Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu
Province, China
3 Department of Neurology, Peixian People’s Hospital, Xuzhou, Jiangsu Province, China
(This article belongs to the Special Issue: Advances in stroke research and therapy)
Abstract
At present, ischemic stroke (IS) is the main contributor to mortality and disability.
As a major chronic non-communicable disease, it poses a major threat to public
health. Adding to the already substantial burden of stroke in China is the rapidly
aging population and the rising incidence of diabetes mellitus, hypertension, and
hyperlipidemia. As a Chinese proverb goes, “diseases invade the body through the
mouth,” which is, coincidentally, consistent with a claim by Hippocrates, the father
of modern medicine, that the source of all diseases begins in the intestines. These
ancient wisdom underscore the importance of dissecting the relationship between IS
and diet. Food is the primary source of trimethylamine N-oxide (TMAO), an intestinal
*Corresponding authors: metabolite, which has drawn a lot of attention because it plays a key role in a number
Shi-Guang Zhu
(sgzhuxyfy@126.com) of pathways linked to the development and progression of atherosclerosis. These
De-Qin Geng pathways include lipid metabolism, vascular endothelial injury, and the induction of
(gengdeqin@126.com) inflammation. Given its potential as a therapeutic target for IS, conducting in-depth
Citation: Yuan Q, Liu Y, Wu B, research on TMAO has become particularly crucial. With varied involvement in
et al. Trimethylamine N-oxide: atherosclerosis, TMAO stands out as a viable target for innovative treatment techniques
A new target for the prevention targeted at decreasing the risk and severity of IS. It is evident that practicing a specific
and treatment of ischemic stroke.
Adv Neuro. 2024;3(3):3005 diet can reduce the risk for IS, underscoring the necessity to investigate the role of
doi: 10.36922/an.3005 controlling dietary TMAO intake in mitigating the risk of IS. At present, a growing body
Received: February 24, 2024 of research has explored the role of TMAO in vascular diseases, uncovering numerous
interventions to reduce TMAO levels, which serve dual benefits of addressing both
Accepted: June 19, 2024
atherosclerosis and the associated risk of IS. This paper reviews the relationship
Published Online: August 23, 2024 between TMAO and IS, along with the progress in research on the clinical value of
Copyright: © 2024 Author(s). TMAO, offering new perspectives on IS prevention and treatment.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution Keywords: Trimethylamine N-oxide; Ischemic stroke; Atherosclerosis
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited.
1. Introduction
Publisher’s Note: AccScience
Publishing remains neutral with Ischemic stroke (IS) has become one of the leading causes of death and disability
regard to jurisdictional claims in
published maps and institutional worldwide. As the incidence and mortality rates of IS continue to rise, it imposes
affiliations. a heavy burden on the socio-economic and public health systems. Traditional risk

Volume 3 Issue 3 (2024) 1 doi: 10.36922/an.3005