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Mechanism of TMAO activation of PERK pathway leading to hypertension. TMAO activates the PERK pathway leading to apoptosis, inflammation, and vascular injury resulting in hypertension. TMAO, trimethylamine N-oxide; IRE1α, inositol-requiring protein 1α; ATF6α3, activating transcription factor 6α3; eIF2α, eukaryotic translation initiation factor 2 subunit-α; NADPH, nicotinamide adenine dinucleotide phosphate oxidase; ROS, reactive oxygen species; Ang II, angiotensin II.
