Gut microbes impact stroke severity via the trimethylamine N-oxide pathway

Fecal microbial transplantation from low- versus high-TMAO-producing human subjects into germ-free mice shows that both TMAO generation and stroke severity are transmissible traits.

• Circulating levels of the metabolite trimethylamine-N-oxide (TMAO) are associated with increased stroke incident risk.
• Gut microbes influence stroke outcomes through dietary choline and the generation of TMAO.
• Transplantation of gut microbiota exhibits a direct impact on cerebral infarct size and functional impairment after stroke.
• The microbial cutC gene is identified as a key contributor to the transformation of choline to TMAO, affecting stroke severity.

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