Trimethylamine-N-oxide (TMAO) is an important biomarker of atherosclerosis. TMAO is the product of a hepatic conversion of trimethylamine (TMA). Releasing of TMA moieties is dependent on the adaptation of the gut microbiota to dietary TMA containing substrates such as phosphatidylcholine (PC), choline, and L-carnitine. A high-fat diet is an environmental risk factor that may increase TMAO production. However, it isn’t clear if the high dietary intake of TMA is sufficient to promote increased plasma TMAO or if a high-fat intake is also required. We hypothesized that TMAO would be increased after consuming a high-fat diet and a high PC diet independently, with greater increases when consumed together. Four groups of twelve mice each were maintained on different treatments that were either low or high-fat with or without PC over two weeks. Then, a meal containing 9.99 g of corn oil and 0.75 g soybean L-α-Lecithin per 1 kg body weight was provided to all mice to indirectly observe the adaptation of the microbiota to the altered diet. The results of circulating TMAO levels showed that fat appeared to suppress TMAO production, which is against previous evidence. The microbial adaptation to the different treatments wasn’t observed in the measurement of fecal TMA levels. As a result, our hypothesis was rejected. Future work addressing the impact of gene expressions of enzymes on the gut and the liver is needed. The use of another high TMA containing substrates such as choline and rats is recommended. / Master of Science in Life Sciences / Cardiovascular disease (CVD) is heart and blood vessel diseases - many of which are caused by atherosclerosis, a condition wherein fatty materials accumulate in the artery wall, reducing blood flow. The compound trimethylamine-N-oxide (TMAO) was found to be an important biomarker of atherosclerosis. TMAO levels increase in the body when gut microbiota releases trimethylamine (TMA) moieties from dietary phosphatidylcholine (PC), choline, and L-carnitine such as eggs and meat. A high-fat intake was believed to have an impact on increased levels of TMAO. However, it wasn’t clear if the dietary intake of high TMA containing substrates such as PC, is sufficient to promote TMAO formation or if a high-fat content is also required. We hypothesized that TMAO would be increased after consuming a high-fat diet and a high PC diet independently, with greater increases when consumed together. The results would suggest new dietary strategies to avoid CVD. Four groups of twelve mice each were maintained on different treatments that were either low or high-fat with or without PC over two weeks. Then, a meal containing corn oil and PC was provided to all mice to observe the adaptation of the microbiota to the altered diet. The results showed that fat reduces circulating TMAO production, which is against previous evidence. Fecal TMA levels showed that microbiota activities weren’t observed in the colon. As a results, no significant levels of TMA and its precursors were observed in feces.

Epidermolysis bullosa simplex (EBS) and epidermolytic ichthyosis (EI) are rare skin fragility diseases characterized by intra-epidermal blistering due to autosomal dominant-negative mutations in basal (KRT5 or KRT14) and suprabasal (KRT1 or KRT10) keratin genes,  respectively. Despite vast knowledge in the disease pathogenesis, the pathomechanisms are not fully understood, and no effective remedies exist. The purpose of this work was to search for keratin gene mutations in EBS patients, to develop in vitro models for studying EBS and EI, and to investigate novel pharmacological approaches for both diseases. We identified both novel and recurrent KRT5 mutations in all studied EBS patients but one which did not show any pathogenic keratin mutations. Using cultured primary keratinocytes from EBS patients, we reproduced a correlation between clinical severity and cytoskeletal instability in vitro. Immortalized keratinocyte cell lines were established from three EBS and three EI patients with different phenotypes using HPV16-E6E7. Only cell lines derived from severely affected patients exhibited spontaneous keratin aggregates under normal culture conditions. However, heat stress significantly induced keratin aggregates in all patient cell lines. This effect was more dramatic in cells from patients with a severe phenotype. In organotypic cultures, the immortalized cells were able to differentiate and form a multilayered epidermis reminiscent of those observed in vivo. Addition of two molecular chaperones, trimethylamine N-oxide dihydrate (TMAO) and sodium 4-phenylbutyrate (4-PBA), reduced the keratin aggregates in both stressed and unstressed EBS and EI keratinocytes, respectively. The mechanism of action of TMAO and 4-PBA was shown to involve the endogenous chaperone system (Heat shock proteins e.g. Hsp70). Besides, MAPK signaling pathways also seemed to be incriminated in the pathogenesis of EBS. Furthermore, depending on which type of keratin is mutated, 4-PBA up-regulated Hsp70 and KRT4 (possibly compensating for mutated KRT1/5), and down-regulated KRT1 and KRT10, which could further assist in protecting EBS and EI cells against stress. In conclusion, novel and recurrent pathogenic keratin mutations have been identified in EBS. Immortalized EBS and EI cell lines that functionally reflect the disease phenotype were established. Two pharmacologic agents, TMAO and 4-PBA, were shown to be promising candidates as novel treatment of heritable keratinopathies in this in vitro model.

Elevated serum levels of trimethylamine N-oxide (TMAO) were first associated with increased risk of cardiovascular disease (CVD) 10 years ago. Research has since defined that serum TMAO accumulation is controlled by the diet-microbiome-liver-kidney axis. Choline related nutrients are consumed in excess during over-nutrition from a Western diet. The resultant elevated serum TMAO is investigated across various chronic metabolic diseases and many tissue types. While TMAO is most clearly linked to CVD mechanisms in vascular tissue, its molecular effects on metabolic tissues are unclear. Here we report the current standing of TMAO research in metabolic disease context across relevant metabolic tissues including liver, kidney, brain, adipose, and muscle tissues. This review explores the variable TMAO effects in healthy and diseased conditions. Since impaired pancreatic β-cell function is a hallmark of metabolic disease pathogenesis which are largely unexplored in TMAO research, the following primary research results investigate TMAO effects on in vitro functional β-cell mass in relation to healthy and type 2 diabetes (T2D) conditions. Although we hypothesized that TMAO would aggravate functional β-cell mass, the data demonstrate that TMAO improves the T2D phenotype by increasing insulin secretion and production and reducing oxidative stress. Therefore, this work provides crucial support for the emerging context dependent molecular effects of TMAO during metabolic disease progression.