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For example, the ingestion of trimethylamine-containing (TMA-containing) dietary nutrients enriched in animal products such as choline, phosphatidylcholine, and l-carnitine can serve as precursor for the ultimate generation of an atherogenic metabolite, trimethylamine N -oxide (TMAO), via a metaorganismal pathway involving initial gut microbial formation of TMA, followed by host hepatic conversion of TMA into TMAO (48)

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Nakashima K, Aoshima M, Ohfuji S, Suzuki K, Katsurada M, Katsurada N, Misawa M, Otsuka Y, Kondo K, Hirota Y (2017) Immunogenicity of trivalent influenza vaccine in patients with lung cancer undergoing anticancer chemotherapy

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