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Recent metabolomics and animal studies showed that TMAO, an intestinal microbiota-dependent metabolite formed from dietary trimethylamine-containing nutrients such as phosphatidylcholine (PC), choline and carnitine, is linked to coronary artery disease pathogenesis, only in the presence of TMA/TMAO generation and intact gut microbiota 35,46

The adenylyl cyclase (AC)/cAMP/PKA cascade may mediate the above H 2 S-induced molecular changes

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Currently, relevant research on P4HA1 is mostly in the stages of basic research and model validation, but preliminary attempts have been made in other cancer fields: A retrospective study on non-small cell lung cancer revealed that high expression of P4HA1 is associated with poor prognosis in patients, providing indirect evidence for its potential as a prognostic marker and therapeutic target (252,253)