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Ethics declarations Competing interests J.F., R.H.Z
Among the numerous physiologically active metabolites of microbial metabolism, TMAO is a biologically active molecule that has been linked to an increased risk of adverse cardiovascular events, including acute coronary syndrome (ACS), stroke, and mortality (47, 158, 159)
Its biosynthesis is a two-step enzymatic cascade, including first a specific -ligation of glutamate and cysteine by -glutamate-cysteine ligase (GCL) and then the formation of peptide bond between this dipeptide and glycine by glutathione synthetase (GS)
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