The healthy, beneficial bacteria that live in the human gut break down choline and produce a compound called TMAO while doing so. However, high levels of TMAO have been linked to a heightened risk for heart disease like heart attack and stroke, a collection of diseases that kill over a quarter of Americans. Neither choline nor the microbiome are the “bad guy” in this situation, though.
Choline is a nutrient that strengthens cell walls and is required for neurotransmitter formation, and the human microbiome fulfills a variety of human health roles like aiding in digestion and boosting the immune system. Reducing TMAO levels; however, could be the key to reducing the risk of heart disease.
In a new study from the Cleveland Clinic published in the journal Cell,
scientists observed more than four thousand patients and animal models, testing their blood levels of TMAO. In their first round of studies, scientists identified a clear correlation between high TMAO levels and increased blood clot potential. Then, in a second study, they saw that TMAO alters platelets’ calcium signaling, increasing their response to clot stimulation when levels are high. In addition, the scientists controlled for various factors:
- traditional cardiac risk factors
- renal function
- markers of inflammation
- medication use
- cardiovascular status
Scientists involved in this study believe that TMAO’s effect on thrombosis potential increases is why high TMAO levels are linked to heart disease. In addition, the current study highlights the “previously unrecognized” connection between choline ingestion, microbiota production of TMAO, and dysfunctional platelets.
"In general, there's a broad range for how quickly different people will form clots,” Hazen said. “However, across the board, when TMAO is elevated, platelet responsiveness jumps to the hyper-reactive side of normal."
Fully understanding the connection between elevated TMAO levels and platelet activity provides a lot of resources for medical professionals looking for new therapeutic targets for improving heart health. Whether it’s interventions to reduce TMAO levels or limiting consumption of certain nutrients for high-risk patients, this study’s findings characterizes several methods for preventing dangerous cardiovascular events.
Source: Cleveland Clinic