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Gram-negative bacteria or LPS in the gut accelerate the formation of cerebral cavernous malformations (CCMs) through the TLR4 pathway, a phenomenon that is not observed in germ-free (GF) mice and in normal mice treated with antibiotics [19]

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doi: 10.3892/ijmm.2021.4900 25 ChiGXuDZhangBYangF

Gut microbiota-dependent trimethylamine n-oxide (tmao) pathway contributes to both development of renal insufficiency and mortality risk in chronic kidney disease

The central question is not simply Is methylation low? It is: Is the dominant problem inadequate SAM production, excessive SAH inhibition, or a combination of both