Figure 3.

Molecular mechanisms of TMAO in cardiovascular diseases. The mechanism of TMAO in cardiovascular diseases has been studied in animal and/or cellular models. TMAO increases the (A) Ca²⁺ release and platelet hyperactivity; (B) TFG-β activation and Smad3 signaling pathway; (C) NLRP3 inflammasome activation, inducing apoptosis; (D) PERK-unfolding protein response (UPR) activation and endoplasmic reticulum stress; and (E) NF-κB translocation and foam cell formation and adhesion. Together, these mechanisms contribute to plaque ruptures, and, therefore, to heart disease. (Created with BioRender.com).