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IMC also prevented diet- driven hepatic cholesterol accumulation, and caused both up-regulation of the host hepatic bile acid synthetic enzyme CYP7A1, and altered the expression of hepatic genes critical for bile acid feedback regulation. These studies suggest that the gut microbiota-driven TMAO pathway is closely linked to both microbe and host sterol and bile acid metabolism. Collectively, as gut microbe-targeting choline TMA lyase inhibitors move through the drug discovery pipeline from preclinical models to human studies, it will be