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Their natural surface charge and protein composition may interact with mucus

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Brunt and colleagues explored the effect and underlying mechanism of TMAO on endothelial dysfunction, they found that TMAO directly impairs vascular endothelial function via superoxide-driven oxidative stress, which is not associated with increased expression of NADPHO, mitochondrial superoxide production or superoxide dismutase (SOD) -related endogenous antioxidant defenses (Brunt et al., 2020)