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TMAO is an oxidative product of TMA in the liver

Among the molecular mechanisms proposed, glutamate excitotoxicity, dysregulation of transcription, altered RNA metabolism, defective axonal transport, protein misfolding and aggregation, endoplasmic reticulum stress, disrupted protein trafficking, proteasome impairment, inflammation, activation of cell death signals, mitochondrial dysfunction, and oxidative stress are the most discussed[2, 2932]

Importantly, the development and application of engineered exosomes offer promising solutions to overcome the current limitations of cancer chemotherapeutic agents