Abstract P3021: Trimethylamine but Not Trimethylamine N-Oxide Increases Blood Pressure in Rats, Affects Viability of Vascular Smooth Muscle Cells and Degrades Protein Structure

Abstract

Increased plasma level of trimethylamine N-oxide (TMAO), a liver metabolite of gut bacteria-produced trimethylamine (TMA), has been suggested to increase cardiovascular risk. Mechanisms of TMAO increase in plasma and biological effects of TMAO are obscure. We evaluated the impact of heart failure (HF) on plasma levels of TMA and TMAO, and biological effects of the molecules. Gut permeability was evaluated in male, 58-week-old Spontaneously Hypertensive Heart Failure (SHHF) and Wistar-Kyoto (WKY) rats. TMA and TMAO levels were assessed using LC-MS. Mean arterial blood pressure (MABP) was measured in anaesthetized, male, 16-week-old WKY treated intravenously with either 0.9% NaCl (vehicle), TMA or TMAO. The cytotoxicity of TMA and TMAO in human vascular smooth muscle cells (hVSMCs) was evaluated using MTT assay. The effect of TMA and TMAO on protein structure of bovine albumin was assessed by fluorescence correlation spectroscopy. WKY showed no pathological changes in the circulatory system. SHHF showed HF with reduced ejection fraction. In comparison to WKY, SHHF had a significantly higher plasma level (μM) of TMA (99.05±6.40 vs 149.30±21.87) and TMAO (5.22±0.61 vs 6.69±0.67). SHHF had a significantly higher plasma-to-stool ratio of TMA, decreased intestinal blood flow and morphological alterations in the colon indicating the increased gut-to-blood penetration of TMA due to HF-induced leaky gut. In WKY treatment with the vehicle and TMAO did not affect MABP. In contrast, TMA (at equimolar doses to TMAO) significantly increased MABP by 5-40 mmHg in a dose dependent manner. In vitro, TMA at a concentration of 500μM reduced hVSMCs viability. TMAO at a concentration of 100mM was not cytotoxic whereas TMA at the same concentration killed cells within 24h. Finally, the incubation of albumin with TMA but not with TMAO resulted in the degradation of the protein structure. In conclusion, HF rats show increased plasma TMA and TMAO, which results from increased gut-to-blood penetration of TMA, a TMAO precursor. TMA but not TMAO affects hemodynamics in rats, reduces viability of cells and degrades protein structure. Therefore, TMA but not TMAO may exert deleterious effects on the circulatory system. Further clinical studies should evaluate not only TMAO but also TMA.