Cited by 355Gut microbiota and healthPharmacogenetics and Drug MetabolismPolyamine Metabolism and Applications

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Trimethylamine and Trimethylamine N-Oxide, a Flavin-Containing Monooxygenase 3 (FMO3)-Mediated Host-Microbiome Metabolic Axis Implicated in Health and Disease

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Fennema, Diede, Phillips, Ian R, Shephard, Elizabeth A·2016·Drug Metabolism and Disposition

DOI 10.1124/dmd.116.070615PMC PMC5074467

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Abstract

Flavin-containing monooxygenase 3 (FMO3) is known primarily as an enzyme involved in the metabolism of therapeutic drugs. On a daily basis, however, we are exposed to one of the most abundant substrates of the enzyme trimethylamine (TMA), which is released from various dietary components by the action of gut bacteria. FMO3 converts the odorous TMA to nonodorous TMA N-oxide (TMAO), which is excreted in urine. Impaired FMO3 activity gives rise to the inherited disorder primary trimethylaminuria (TMAU). Affected individuals cannot produce TMAO and, consequently, excrete large amounts of TMA. A dysbiosis in gut bacteria can give rise to secondary TMAU. Recently, there has been much interest in FMO3 and its catalytic product, TMAO, because TMAO has been implicated in various conditions affecting health, including cardiovascular disease, reverse cholesterol transport, and glucose and lipid homeostasis. In this review, we consider the dietary components that can give rise to TMA, the gut bacteria involved in the production of TMA from dietary precursors, the metabolic reactions by which bacteria produce and use TMA, and the enzymes that catalyze the reactions. Also included is information on bacteria that produce TMA in the oral cavity and vagina, two key microbiome niches that can influence health. Finally, we discuss the importance of the TMA/TMAO microbiome-host axis in health and disease, considering factors that affect bacterial production and host metabolism of TMA, the involvement of TMAO and FMO3 in disease, and the implications of the host-microbiome axis for management of TMAU.

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Authors: Fennema, D., Phillips, I. R., & Shephard, E. A.
Affiliations: Queen Mary University of London (GB)
Corresponding author: Shephard, Elizabeth A
ORCID: Fennema, Diede
Phillips, Ian R
Shephard, Elizabeth A
Venue: Drug Metabolism and Disposition
Publisher: Elsevier BV
Published: 2016-11
Volume: 44
Issue: 11
Pages: 1839-1850
ISSN: 0090-9556 (ISSN-L)
DOI: 10.1124/dmd.116.070615
PMC: PMC5074467
OpenAlex: W2397682060
Cited by: 355
References: 192
Citations by year: 2026: 22 · 2025: 39 · 2024: 48 · 2023: 30 · 2022: 36 · 2021: 56 · 2020: 52 · 2019: 36 · 2018: 20 · 2017: 15
FWCI: 2.14
Type: journal article
Language: en
Update notices: erratum (2016-12-01)
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by/4.0/ (vor, 2983 d)
Locations: Drug Metabolism and Disposition (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Funders: Medical Research Council (MR/K015494/1)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Polyamine Metabolism and Applications
Keywords: trimethylamine, trimethylamine N-oxide, FMO3, trimethylaminuria, gut microbiota, dietary precursors, oral microbiota, vaginal microbiota, cardiovascular disease, reverse cholesterol transport, glucose and lipid homeostasis
MeSH terms: Gastrointestinal Microbiome, Animals, Cardiovascular Diseases, Humans, Methylamines, Oxygenases, Host-Pathogen Interactions

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Trimethylamine and Trimethylamine N-Oxide, a Flavin-Containing Monooxygenase 3 (FMO3)-Mediated Host-Microbiome Metabolic Axis Implicated in Health and Disease

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