Stroke and Vascular Cognitive Impairment: The Role of Intestinal Microbiota Metabolite TMAO

CNS Neurol Disord Drug Targets. 2023 Feb 3. doi: 10.2174/1871527322666230203140805. Online ahead of print.ABSTRACTThe gut microbiome interacts with the brain bidirectionally through the microbiome-gut-brain axis, which plays a key role in regulating various nervous system pathophysiological processes. Trimethylamine N-oxide (TMAO) is produced by choline metabolism through intestinal microorganisms, which can cross the blood-brain barrier to act on the central nervous system. Previous studies have shown that elevated plasma TMAO concentrations increase the risk of major adverse cardiovascular events, but there are few studies on TMAO in cerebrovascular disease and vascular cognitive impairment. This review summarized a decade of research on the impact of TMAO on stroke and related cognitive impairment, with particular attention to the effects on vascular cognitive disorders. We demonstrated that TMAO has a marked impact on the occurrence, development, and prognosis of stroke by regulating cholesterol metabolism, foam cell formation, platelet hyperresponsiveness and thrombosis, and promoting inflammation and oxidative stress. TMAO can also influence the cognitive impairment caused by Alzheimer's disease and Parkinson's disease via inducing abnormal aggregation of key proteins, affecting inflammation and thrombosis. However, although clinical studies have confirmed the association between the microbiome-gut-brain axis and vascular cognitive impairment (cerebral small vessel dise...
Source: CNS and Neurological Disorders Drug Targets - Category: Drugs & Pharmacology Authors: Source Type: research