The contributory role of gut microbiota in cardiovascular disease

J Clin Invest. 2014 Oct;124(10):4204-11. doi: 10.1172/JCI72331. Epub 2014 Oct 1.


Our group recently discovered that certain dietary nutrients possessing a trimethylamine (TMA) moiety, namely choline/phosphatidylcholine and L-carnitine, participate in the development of atherosclerotic heart disease. A meta-organismal pathway was elucidated involving gut microbiota-dependent formation of TMA and host hepatic flavin monooxygenase 3-dependent (FMO3-dependent) formation of TMA-N-oxide (TMAO), a metabolite shown to be both mechanistically linked to atherosclerosis and whose levels are strongly linked to cardiovascular disease (CVD) risks. Collectively, these studies reveal that nutrient precursors, gut microbiota, and host participants along the meta-organismal pathway elucidated may serve as new targets for the prevention and treatment of CVD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Atherosclerosis / complications
  • Atherosclerosis / microbiology
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / microbiology*
  • Carnitine / chemistry
  • Choline / chemistry
  • Diet
  • Female
  • Food
  • Humans
  • Intestines / microbiology*
  • Male
  • Methylamines / chemistry
  • Microbiota*
  • Oxygenases / chemistry
  • Phosphatidylcholines / chemistry


  • Methylamines
  • Phosphatidylcholines
  • Oxygenases
  • dimethylaniline monooxygenase (N-oxide forming)
  • trimethyloxamine
  • trimethylamine
  • Choline
  • Carnitine