Cited by 291Parathyroid Disorders and TreatmentsDermatological and Skeletal DisordersInflammasome and immune disorders

Trimethylamine-N-Oxide Promotes Vascular Calcification Through Activation of NLRP3 (Nucleotide-Binding Domain, Leucine-Rich-Containing Family, Pyrin Domain-Containing-3) Inflammasome and NF-κB (Nuclear Factor κB) Signals

Open access
Zhang, Xiuli, Li, Yining, Yang, Pingzhen, Liu, Xiaoyu, Lu, Lihe, Chen, Yanting, Zhong, Xinglong, Li, Zehua +4 more·2020·Arteriosclerosis, Thrombosis, and Vascular Biology

Abstract

Objectives: Vascular calcification is highly prevalent in patients with chronic kidney disease. Increased plasma trimethylamine N-oxide (TMAO), a gut microbiota-dependent product, concentrations are found in patients undergoing hemodialysis. However, a clear mechanistic link between TMAO and vascular calcification is not yet established. In this study, we investigate whether TMAO participates in the progression of vascular calcification using in vitro, ex vivo, and in vivo models. Approach and Results: Alizarin red staining revealed that TMAO promoted calcium/phosphate-induced calcification of rat and human vascular smooth muscle cells in a dose-dependent manner, and this was confirmed by calcium content assay. Similarly, TMAO upregulated the expression of bone-related molecules including Runx2 (Runt-related transcription factor 2) and BMP2 (bone morphogenetic protein-2), suggesting that TMAO promoted osteogenic differentiation of vascular smooth muscle cells. In addition, ex vivo study also showed the positive regulatory effect of TMAO on vascular calcification. Furthermore, we found that TMAO accelerated vascular calcification in rats with chronic kidney disease, as indicated by Mico-computed tomography analysis, alizarin red staining and calcium content assay. By contrast, reducing TMAO levels by antibiotics attenuated vascular calcification in chronic kidney disease rats. Interestingly, TMAO activated NLRP3 (nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3) inflammasome and NF-κB (nuclear factor κB) signals during vascular calcification. Inhibition of NLRP3 inflammasome and NF-κB signals attenuated TMAO-induced vascular smooth muscle cell calcification. Conclusions: This study for the first time demonstrates that TMAO promotes vascular calcification through activation of NLRP3 inflammasome and NF-κB signals, suggesting the potential link between gut microbial metabolism and vascular calcification. Reducing the levels of TMAO could become a potential treatment strategy for vascular calcification in chronic kidney disease.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1161/atvbaha.119.313414

Cites

59 of 59 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Trimethylamine N-oxide has been shown to promote platelet reactivity and thrombosis potential, vascular inflammation and inflammasome activation, and heightened heart failure and chronic kidney disease related phenotypes in animal models.

    “It has also been shown to promote platelet reactivity and thrombosis potential14, 83–85, vascular inflammation and inflammasome activation86–88, heightened heart failure89–91 and CKD92–95 related phenotypes in animal models (Figure 2).”

    From Gut microbiota and cardiovascular disease. (2020) · cites this paper as [88]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Zhang, X., Li, Y., Yang, P., Liu, X., Lu, L., Chen, Y., Zhong, X., Li, Z., Liu, H., Ou, C., Yan, J., & Chen, M.
Affiliations
  • Zhujiang Hospital (CN)
  • Sun Yat-sen University (CN)
Corresponding author
  • Zhang, Xiuli
  • Li, Yining
  • Yang, Pingzhen
Venue
Arteriosclerosis, Thrombosis, and Vascular Biology
Published
2020-03
Volume
40
Issue
3
Pages
751-765
ISSN
  • 1079-5642 (ISSN-L)
  • 1524-4636
OpenAlex
W2999495572
Cited by
291
References
59
Citations by year
2026: 45 · 2025: 60 · 2024: 53 · 2023: 42 · 2022: 46 · 2021: 32 · 2020: 13
FWCI
20.87
Type
journal article
Language
en
Open access
Locations
  • Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Natural Science Foundation of China (81870190, U1501222, 31771060, 81871504, 81770280)
  • Science and Technology Planning Project of Guangdong Province (2017A020215184)
  • Basic and Applied Basic Research Foundation of Guangdong Province (2019A1515010682)
Topics
  • Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Dermatological and Skeletal Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Inflammasome and immune disorders
Keywords
trimethylamine N-oxide, vascular calcification, NLRP3 inflammasome, NF-κB signaling, chronic kidney disease, vascular smooth muscle cells, osteogenic differentiation, Runx2, BMP-2, gut microbiota, antibiotics, hemodialysis
MeSH terms
NLR Family, Pyrin Domain-Containing 3 Protein, Adult, Aged, Animals, Anti-Bacterial Agents, Aorta, Thoracic, Cells, Cultured, Disease Models, Animal, Female, Humans, Male, Methylamines, Middle Aged, Muscle, Smooth, Vascular, Osteogenesis, Signal Transduction, NF-kappa B, Tibial Arteries, Myocytes, Smooth Muscle, Tissue Culture Techniques, Renal Insufficiency, Chronic, Inflammasomes, Vascular Calcification

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review