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doi: 10.1371/journal.pone.0179124 149 BlombergJRizwanMBhlin-WienerAElfaitouriAJulinPZachrissonOet al

(2017) observed that TMAO treatment promoted monocyte adhesion through upregulation of vascular cell adhesion molecule-1 (VCAM-1) but not the other adhesion molecules (i.e., intercellular adhesion molecule-1 (ICAM-1) and E-selectin) expression in human umbilical vein endothelial cells in vitro

Notably, acetylcarnitine can act as an acetyl donor [37], supporting the acetylation process of cells through the shuttle mechanism of acetylcarnitine in the absence of conventional acetyl-CoA synthetase enzymes such as ATP-citrate lyase (ACLY) and acyl-CoA synthetase short chain 2 (ACSS2) [38]

Since these pathogen proteins and metabolites are often similarly structured to ones created by the human host, such molecular mimicry makes it difficult for the host to recognise the foreign pathogen (193), resulting in the hosts immune system becoming increasingly sluggish and more susceptible to acquiring other infectious agents