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Atherosclerosis is primarily characterized by inflammation, disrupted blood flow, and arterial wall remodeling, substantially influenced by excess reactive oxygen species (ROS) (He and Zuo 2015)

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Serratia bacteria and Acinetobacter calcoaceticus that found in the human gut can cleave the 3-hydroxybutyryloxy group of L-carnitine to directly produce TMA (Meadows and Wargo, 2015)

It was first described for the treatment of PD in 1948 (9) and, due to its low cost and availability, remains the most frequently prescribed oral agent for PD (10)