Cited by 427Endoplasmic Reticulum Stress and DiseaseGut microbiota and healthPer- and polyfluoroalkyl substances research

Trimethylamine N-Oxide Binds and Activates PERK to Promote Metabolic Dysfunction

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Chen, Sifan, Henderson, Ayana, Petriello, Michael C., Romano, Kymberleigh A., Gearing, Mary, Miao, Ji, Schell, Mareike, Sandoval-Espinola, Walter J. +9 more·2019·Cell Metabolism

Abstract

The gut-microbe-derived metabolite trimethylamine N-oxide (TMAO) is increased by insulin resistance and associated with several sequelae of metabolic syndrome in humans, including cardiovascular, renal, and neurodegenerative disease. The mechanism by which TMAO promotes disease is unclear. We now reveal the endoplasmic reticulum stress kinase PERK (EIF2AK3) as a receptor for TMAO: TMAO binds to PERK at physiologically relevant concentrations; selectively activates the PERK branch of the unfolded protein response; and induces the transcription factor FoxO1, a key driver of metabolic disease, in a PERK-dependent manner. Furthermore, interventions to reduce TMAO, either by manipulation of the gut microbiota or by inhibition of the TMAO synthesizing enzyme, flavin-containing monooxygenase 3, can reduce PERK activation and FoxO1 levels in the liver. Taken together, these data suggest TMAO and PERK may be central to the pathogenesis of the metabolic syndrome.

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Crossref · 10.1016/j.cmet.2019.08.021

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  • TMAO directly binds to PERK, a main component of the unfolded protein response.

    “Chen et al. showed that TMAO directly binds to protein kinase R-like endoplasmic reticulum kinase (PERK), a main component of the unfolded protein response – a signaling pathway that adapts the cell to ER stress133 (Figure 1).”

    From Gut microbiota and cardiovascular disease. (2020) · cites this paper as [133]

  • Dietary supplementation of TMAO in C57BL/6J wildtype animals induces hepatic PERK expression, accompanied by increased Fox01 and impaired glycemic control.

    “Dietary supplementation of TMAO in C57BL/6J wildtype animals induced hepatic PERK expression, accompanied by increased Fox01, a key transcription factor in insulin singling and impaired glycemic control.”

    From Gut microbiota and cardiovascular disease. (2020) · cites this paper as [133]

  • Absence of hepatic PERK blunts TMAO-induced increases in Fox01 expression and improves glycemic indices.

    “Genetic manipulation demonstrated that the absence of hepatic PERK blunted the TMAO-induced increases in Fox01 expression and improved glycemic indices.”

    From Gut microbiota and cardiovascular disease. (2020) · cites this paper as [133]

  • A receptor for TMAO has been reported and shown to participate in TMAO-dependent effects on glucose and insulin metabolism.

    “Recently, a receptor for TMAO has been reported and shown to participate in TMAO-dependent effects on glucose and insulin metabolism133.”

    From Gut microbiota and cardiovascular disease. (2020) · cites this paper as [133]

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Authors
Chen, S., Henderson, A., Petriello, M. C., Romano, K. A., Gearing, M., Miao, J., Schell, M., Sandoval-Espinola, W. J., Tao, J., Sha, B., Graham, M., Crooke, R., Kleinridders, A., Balskus, E. P., Rey, F. E., Morris, A. J., & Biddinger, S. B.
Affiliations
  • Boston Children's Hospital (US)
  • University of Kentucky (US)
  • University of Wisconsin–Madison (US)
  • German Center for Diabetes Research (DE)
  • University of Alabama at Birmingham (US)
  • Ionis Pharmaceuticals (United States) (US)
  • Harvard University (US)
Corresponding author
Biddinger, Sudha B.
Venue
Cell Metabolism
Publisher
Elsevier BV
Published
2019-12
Volume
30
Issue
6
Pages
1141-1151.e5
ISSN
1550-4131 (ISSN-L)
OpenAlex
W2973552995
Cited by
427
References
88
Citations by year
2026: 60 · 2025: 84 · 2024: 63 · 2023: 69 · 2022: 60 · 2021: 50 · 2020: 36 · 2019: 2 · 2018: 1
FWCI
19.49
Type
journal article
Language
en
Open access
Locations
  • Cell Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • Bundesministerium für Bildung und Forschung
  • American Heart Association (R01HL109650)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Endoplasmic Reticulum Stress and Disease
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
Keywords
trimethylamine N-oxide, PERK, unfolded protein response, endoplasmic reticulum stress, FOXO1, gut microbiota, FMO3, metabolic syndrome, insulin resistance, liver
MeSH terms
Gastrointestinal Microbiome, Animals, Humans, Indoles, Insulin Resistance, Methylamines, Mice, Inbred C57BL, Mice, Obese, Oxygenases, Mice, Knockout, eIF-2 Kinase, Metabolic Syndrome, Mice, Hep G2 Cells, HEK293 Cells

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