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Donnelly J, Popovich PG

Its downregulation is associated with 5-CpG island hypermethylation and altered histone acetylation (H3/H4 acetylation loss)

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Avoid repeated freeze-thaw cycles and protect from direct light

TMAO reduces bile acid pools, inhibiting FXR activity, disrupting bile acid-FXR signaling, and upregulating pathways worsening hepatic steatosis, as confirmed in HFD-fed C57BL/6J mice and human samples (154)