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Pharmacological inhibition of TMA lyase by 3,3-dimethyl-1-butanol (DMB) in imiquimod-induced lupus models demonstrates multi-organ protection through TMAO suppression, including endothelial function restoration and macrophage foam cell formation inhibition independent of cholesterol modulation ( Complementary studies reveal diverse TMAO modulation strategies: Puerarin exerts atheroprotection via Prevotella copri depletion and TMA precursor reduction, while berberines vitamin-mimetic metabolite dihydroberberine disrupts gut microbial TMA biosynthesis (165, 166)