Research progress on TMAO in etiological subtypes and therapeutic approaches for ischemic stroke
Wang Yukun
Zhou Chu
Hu Yeju
Sun Yong
Zhai Yujia
Ping Lei
Zhu Shiguang
Abstract：In recent years,the gut microbiota metabolite trimethylamine N-oxide(TMAO)has been confirmed to be closely associated with the occurrence and development of cardiovascular diseases and ischemic stroke.Studies have shown that TMAO may exacerbate atherosclerosis by promoting endothelial dysfunction,foam cell formation,platelet hyperreactivity,and thrombosis,thereby increasing the risk of large artery atherosclerosis(LAA)stroke.At the same time,TMAO may be involved in the pathological process of cardioembolism(CE)by inducing cardiac fibrosis,susceptibility to atrial fibrillation,and thrombosis.In small artery occlusion(SAO)stroke,it may aggravate small vessel lesions by affecting glucose and lipid metabolism.Although previous studies have proposed methods,such as diet,probiotics,antibacterial drugs,and statins,to reduce TMAO levels,the clinical effects of these interventions are not yet fully clear.In particular,there is still controversy regarding the impact of TMAO on the efficacy of antiplatelet drugs.Future research should explore the causal relationship between TMAO and stroke subtypes and evaluate its potential for clinical intervention,with the aim of optimizing the prevention and treatment strategies for ischemic stroke.
Keywords：TMAOIschemic strokeTOAST classificationGut microbiotaTreatment strategy
Publication Date：2025-01-20
Online Publishing Date：2025-10-31(First online date of this platform, not the publication date of the document)
Pages：8( 66-73 )